FROM ONCOLOGIST TO SURGEON - GENETICS IN COLORECTAL METASTASIS FOR SURGEONS

Area of Science:

• Oncology
• Gastroenterology
• Genetics

Background:

• Colorectal cancer (CRC) presents significant health challenges, with high incidence rates in Brazil.
• CRC risk factors are broadly categorized into environmental and hereditary, influencing disease presentation as sporadic, inherited, or familial.
• Sporadic CRC, common over age 50, lacks family history and is linked to diet and environment, accounting for ~70% of cases.

Purpose of the Study:

• To review the etiological factors of colorectal cancer (CRC).
• To differentiate between sporadic, inherited, and familial forms of CRC.
• To highlight the role of polyps and genetic syndromes in CRC development and management.

Main Methods:

• Literature review of colorectal cancer risk factors and classifications.
• Analysis of etiological pathways including environmental, hereditary, and genetic predispositions.
• Examination of specific genetic syndromes associated with CRC, such as Lynch syndrome and various polyposis conditions.

Main Results:

• Sporadic CRC, driven by environmental and dietary factors, constitutes the majority of cases (~70%).
• Hereditary factors account for less than 10% of CRC, often manifesting with colonic polyps.
• Identified hereditary conditions include Lynch syndrome (HNPCC), familial adenomatous polyposis (FAP), MUTYH-associated polyposis (MAP), and hamartomatous polyposis syndromes.

Conclusions:

• Effective CRC management requires understanding its diverse origins, from lifestyle to genetic predispositions.
• Genetic syndromes like Lynch syndrome and polyposis significantly elevate cancer risk.
• Advances in targeted therapies and biomarker analysis are crucial for treating metastatic CRC.