Resumo
Definição
História e exame físico
Principais fatores de diagnóstico
- presença de fatores de risco
- idade mais avançada
- sangramento retal
- alteração no hábito intestinal
- massa retal
- história familiar positiva
- massa abdominal
Outros fatores de diagnóstico
- anemia
- sexo masculino
- dor abdominal
- perda de peso e anorexia
- distensão abdominal
- linfonodos palpáveis
Fatores de risco
- idade mais avançada
- mutação de polipose adenomatosa do cólon
- Síndrome de Lynch (câncer colorretal hereditário sem polipose)
- polipose associada ao MYH
- síndromes da polipose hamartomatosa
- doença inflamatória intestinal
- obesidade
- acromegalia
- atividade física limitada
- ausência de fibras alimentares
Exames diagnósticos
1° exames a serem solicitados
- Hemograma completo
- bioquímica hepática
- função renal
- colonoscopia
- enema de bário com duplo contraste
- colonografia por TC
- TC do tórax, abdome e pelve
Exames a serem considerados
- ressonância nuclear magnética (RNM) pélvica
- ultrassonografia endoscópica transrretal (USTR)
- biópsia
- antígeno carcinoembriogênico (CEA)
- tomografia por emissão de pósitrons (PET)
Algoritmo de tratamento
Colaboradores
Autores
Associate Dean Clinical Operations
Chair
Department of Surgery
Drexel University College of Medicine
Philadelphia
PA
Divulgações
DES declares that he has no competing interests.
Chief
Division of Colorectal Surgery
Department of Surgery
Drexel University
Philadelphia
PA
Divulgações
JLP declares that he has no competing interests.
Assistant Professor of Medicine
Department of Surgery
Drexel University
Philadelphia
PA
Divulgações
JR declares that he has no competing interests.
Dr David E. Stein, Dr Juan L. Poggio, and Dr Jascha Rubin would like to gratefully acknowledge Dr Najjia Mahmoud, Dr Emily Carter Paulson, Dr Gary Atkin, Dr Anne Ballinger, Dr Mark O'Hara, Dr Mark Harrison, and Dr Robert Glynne-Jones, previous contributors to this topic.
Divulgações
NM, ECP, MOH, GA, and AB declare that they have no competing interests. MH is the chair of the Mount Vernon Upper GI Tumour Site Specific Group and a member of the National Cancer Research Institute anal, rectal, and advanced colorectal groups. He has also received honoraria for speaking and has been supported to attend international meetings in GI cancer from Roche. He has also received research funding from Pfizer for a trial in rectal cancer. RGJ is the chief medical adviser to the charity Bowel Cancer UK. He has received honoraria for lectures from Roche, Sanofi, and Pfizer. He has received funding for the EXTRA study, involving capecitabine and radiotherapy in anal cancer, published in the International Journal of Radiation Biology Physics. RGJ has also received funding and free cetuximab for an ongoing phase I/II study integrating cetuximab into chemoradiation in rectal cancer, and has an agreement from Roche to supply bevacizumab for 3 months to 60 patients in one randomised phase II study as neoadjuvant chemotherapy in rectal cancer (BACCHUS). He has also been supported by Roche to attend international meetings in GI cancer.
Colegas revisores
Consultant Colorectal Surgeon
St Mark's Hospital and Academic Institute
Northwick Park
Middlesex
UK
Divulgações
SC declares that she has no competing interests.
Chief of Staff
Chairman
Department of Colorectal Surgery
Cleveland Clinic
Weston
FL
Divulgações
SW declares that he has no competing interests.
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