Colorectal Cancer: Locoregional Disease

Colorectal cancer (CRC) is the third most common diagnosed tumour in men and the second in women. In countries with surveillance programs, mortality has declined progressively due to increased detection of early tumours, amenable to definitive treatment. Environmental and genetic factors play key roles in its aetiology. Three mechanisms are implicated in CRC carcinogenesis: chromosomal instability (CIN), microsatellite instability (MSI) and CpG island methylator phenotype (CIMP). Colon and rectal tumours are biologically considered as a unique entity; however rectal cancer management differs from colon cancer with regard to perioperative treatment. An appropriate diagnostic work-up, within the multidisciplinary team, is important to define CRC therapeutic strategy.