Cohort Definition Name: Primary adenocarcinoma of the colon or rectum
Contributor name: Andreas Weinberger Rosen
Contributor OrcId: 0000-0001-9990-8155
Logic Description: First event of primary adenocarcinoma of the colon or rectum
Recommended study application: exposure, outcome, indication
Assertion statement: This cohort definition was executed on at least one real person-level observational health data source and resulted in a cohort with at least 1 person.
Submitted cohort definition:
Primary adenocarcinoma of the colon or rectum.txt.txt (38.2 KB)
Target Clinical Description
The primary adenocarcinoma of the colon or rectum is the most common malignant neoplasm of the intestine and is commonly called colorectal cancer or bowel cancer. The disease originates from the epithelial cells of the colon or rectum and through several molecular pathways can develop into a malignant tumor. Depending on anatomical location, size, and stage several clinical presentations are possible.
Presentation of colorectal cancer
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Common presentations for colorectal cancer:
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Blood in stool
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Diarrhea
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Constipation
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The feeling of having to empty bowel but nothing passes
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Abdominal pain or discomfort
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Weight loss
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Night sweats
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Anemia
Many patients are asymptomatic and might be diagnosed through screening programs or accidental findings through other assignments
Colorectal cancer can also present as emergency cases with bowel obstruction, lower gastrointestinal hemorrhage, or perforation of the bowel
Assessment for colorectal cancer
Colonoscopy for gross inspection of tumor and biopsy of lesion
Histopathological assessment of biopsy is a common foundation for diagnosis
Imaging, e.g. CT, PET, MR for clinical staging
Histopathological assessment of surgical specimen or metastatic lesion for pathological staging
Differential diagnosis of colorectal cancer
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Other neoplasias of the intestine e.g. neuroendocrine tumors or high-grade polyps
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Diverticulitis
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Hemorrhoids
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Anal fissures
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Irritable bowel syndrome
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Inflammatory bowel disease
Treatment plan for colorectal cancer
For localized or regional colorectal cancer resection of the tumor and the affected segment of the intestine is the standard treatment. This can be combined with neoadjuvant or adjuvant oncological therapy including antineoplastic drugs or radiation therapy,
For patients with solitary metastasis radical surgery might be combined with radiofrequency ablation, stereotactic radiation, or metastasis surgery and oncological treatment for a curative treatment option.
For patients without a curative intended treatment, palliative oncological treatment and palliative surgery might be used to prolong life or better symptoms.
For patients with the molecular subtype ‘deficient mismatch repair’ or microsatellite instability-high, treatment with immune checkpoint inhibitors might be possible.
Prognosis for colorectal cancer
The prognosis of colorectal cancer depends on several factors but is generally favorable if diagnosed at an early stage and treated with radical surgery. While patients with widespread metastases or those presented with symptoms requiring emergency surgery have a worse prognosis.
Assignment for Peer Review:
Peer review of the phenotype would be more than welcome