Incidence and Mortality
Estimated new cases and deaths from rectal cancer in the United States in 2014:
New cases: 40,000 (rectal cancer only).
Deaths: 50,310 (colon and rectal cancers combined).
It is difficult to separate epidemiological considerations of rectal cancer from those of colon cancer because epidemiological studies often consider colon and rectal cancer (i.e., colorectal cancer) together.
Worldwide, colorectal cancer is the third most common...
Updated statistics with estimated new cases and deaths for 2014 (cited American Cancer Society as reference 1).
Added text to state that limited data and no level 1 evidence are available to guide patients and physicians about surveillance and management of patients after surgical resection and adjuvant therapy. The American Society of Clinical Oncology and the National Comprehensive Cancer Network recommend specific surveillance and follow-up strategies (cited Meyerhardt et al. and Benson et al. as references 25 and 26, respectively).
Revised text to state that to date, no large-scale randomized trials have documented an overall survival (OS) benefit for standard, postoperative monitoring program.
Added Factors Associated with Recurrence as a new subsection.
Revised text of subsection title to read Neoadjuvant chemotherapy for unresectable liver metastases.
Added text to state that there is no consensus on the best regimen to use to convert unresectable isolated liver metastases to resectable liver metastases.
Revised text of subsection title to read Adjuvant or neoadjuvant chemotherapy for resectable liver metastases.
Revised Adjuvant or neoadjuvant chemotherapy for resectable liver metastases subsection.
Added text to provide evidence about intra-arterial chemotherapy after liver resection and included statistics related to two trials that evaluated hepatic arterial floxuridine in the adjuvant setting after liver resection (cited 1999 Kemeny et al. as reference 43 and level of evidence IiiA and 2002 Kemeny as reference 44).
Added text to state that further studies are required to evaluate this treatment approach and to determine whether more effective systemic combination chemotherapy alone may provide similar results compared with hepatic intra-arterial therapy plus systemic treatment.
Added text to include regorafenib to list of nine active and approved drugs for patients with metastatic colorectal cancer.
Revised text to state that before the availability of cetuximab, panitumumab, bevacizumab, and aflibercept as second-line therapy, second-line chemotherapy with irinotecan in patients treated with 5-FU/LV as first-line therapy demonstrated improved OS when compared with either infusional 5-FU or supportive care.