Última revisão: 20 Set 2021
Última atualização: 29 Mar 2021

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • idade mais avançada
  • sangramento retal
  • alteração no hábito intestinal
  • massa retal
  • história familiar positiva
  • massa abdominal

Outros fatores diagnósticos

  • 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/MUTYH
  • síndromes da polipose hamartomatosa
  • doença inflamatória intestinal
  • obesidade
  • acromegalia
  • atividade física limitada
  • ausência de fibras alimentares

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • hemograma completo
  • bioquímica hepática
  • função renal
  • colonoscopia
  • colonografia por TC
  • enema de bário com duplo contraste
  • TC do tórax, abdome e pelve

Investigações a serem consideradas

  • Protocolo para RNM de pelve para câncer retal
  • ultrassonografia endoscópica transrretal (USTR)
  • biópsia
  • antígeno carcinoembriogênico (CEA)
  • tomografia por emissão de pósitrons (PET)

Novos exames

  • técnicas avançadas de imagem óptica

Algoritmo de tratamento

Colaboradores

Autores

David E. Stein, MD, FACS, FASCRS

Regional Chief of Surgery

MedStar Health

Baltimore

MD

Declarações

DES declares that he has no competing interests.

David M. Lisle, MD

Associate Program Director

Department of Surgery

MedStar Franklin Square Medical Center

Baltimore

MD

Declarações

DML declares that he has no competing interests.

Pallavi P. Kumar, MD

Co-Director of Medical Oncology

Director of Immuno-Oncology

MedStar Franklin Square Medical Center

Harry and Jeanette Weinberg Cancer Institute

Baltimore

MD

Declarações

PPK declares that she has no competing interests.

Kamila A. Nowak-Choi, MD

Department of Radiation Oncology

MedStar Franklin Square Medical Center

Baltimore

MD

Declarações

KANC declares that she has no competing interests.

Agradecimentos

Dr David E. Stein, Dr David M Lisle, Dr Pallavi P Kumarm and Dr Kamila A Nowak-Choi would like to gratefully acknowledge Dr Juan L. Poggio, Dr Jascha Rubin, 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.

Declarações

JLP, JR, 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.

Revisores

Susan Clark, BChir, MB

Consultant Colorectal Surgeon

St Mark's Hospital and Academic Institute

Northwick Park

Middlesex

UK

Declarações

SC declares that she has no competing interests.

Steven Wexner, MD, FACS, FRCS, FRCS Ed, FASCRS, FAC

Chief of Staff

Chairman

Department of Colorectal Surgery

Cleveland Clinic

Weston

FL

Declarações

SW declares that he has no competing interests.

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