Carcinoma of the Rectum Lecture Notes

These flashcards cover key concepts, definitions, and important details associated with carcinoma of the rectum, as discussed in the lecture.

What is the most common type of rectal cancer?

More than 95% of rectal cancers are adenocarcinomas.

At what age does the peak incidence of rectal carcinoma occur?

The peak incidence is between 60-70 years.

What diet and lifestyle factors are associated with increased risk for rectal cancer?

High intake of red/processed meat, animal fat, low dietary fiber, obesity, smoking, and heavy alcohol consumption.

Which inflammatory bowel disease carries a significantly higher risk for rectal cancer?

Ulcerative Colitis carries a significantly higher risk than Crohn's disease.

What is the primary genetic syndrome associated with a 100% lifetime risk of colorectal cancer?

Familial Adenomatous Polyposis (FAP).

What is the most common macroscopic appearance of rectal cancer?

Ulcerative form, presenting with a raised, everted rolled-out edge and a necrotic base.

Name one aggressive variant of adenocarcinoma found in the rectum.

Mucinous or Signet-ring cell carcinomas.

How does rectal cancer typically spread?

It spreads via direct invasion, lymphatic spread, and hematogenous spread.

What is the most common early symptom of rectal cancer?

Bleeding per rectum.

What does a Digital Rectal Examination (DRE) assess?

It assesses the tumor's distance from the anal verge, size, mobility, and ulceration.

What imaging is the gold standard for local staging of rectal cancer?

MRI Pelvis.

What is the aim of neoadjuvant therapy in rectal cancer management?

To downstage the tumor, increase the chance of sphincter-preserving surgery, and reduce local recurrence rates.

What surgical procedure involves sharp dissection in the avascular embryonic plane?

Total Mesorectal Excision (TME).

What is the usual post-operative treatment for node-positive disease in rectal cancer?

Systemic chemotherapy (e.g., FOLFOX or CAPOX regimens).

What is the significance of the Circumferential Resection Margin (CRM) in rectal cancer?

Assessing the CRM is crucial to determine if neoadjuvant therapy is needed.