GI Flashcards
- Anal canal S&S
- Colorectal S&S
- Esophagus S&S
- Stomach S&S
- Rectal bleeding
- asymptomatic–>abdominal pain and rectal bleeding
- dysphagia and wt loss
- anorexia
Epi/Eti
- Anal canal
- Colorectal
- Esophagus
- Stomach
- increase in women & HPV 16
- increase in males & increase BMI, chronic ulcerative colitis, hereditary
- increase in males & SCC: alcohol and tobacco
Adeno: barretts esophagus - more common than esophagus and anal canal combined, increase in males & H.pylori infx and tobacco
Prognostic indicators in
- Anal canal
- Colorectal
- Esophagus
- Stomach
- stage
- stage
- R status
- stage
Pathology in
- Anal canal
- Colorectal
- Esophagus
- Stomach
- SCC
- Adenocarcinoma
- SCC: upper and middle
Adeno; lower 1/2 + GE jxn (barrets esophagus) - Adenocarcinoma
Anal canal dose
*Sx is no longer initial tx
Chemo RT
- primary: 54-60
- LN 30-50
RT only
- primary: 60-65
- LN: 30-50
Colon dose
tumour bed +3-5cm margin=45Gy
then reduced fields to 50.4-54
Stomach Dose
post-op ChemoRT
45-50.4Gy
field reduction after 45Gy
Rectum dose
Long course
- PH 1: primary, LN & margins 45Gy/25
- PH 2: includes primary and margin 540/3\
Short course
-Single phase 25/5
Esophagus Dose
Neo-adj chemo RT followed by sx (5cm)
4140/23
RT only
45Gy +15-20Gy boost=60-65
RTchemo only
45Gy +540/28
Colon Disease Management
sx primary tx
T1-T2 no RT just sx
Stage III-chemo
Rectum Disease Management
Sx primary tx
most disease require LAR (upper) and APR (lower)
RT Chemo pre-op
Esophagus Disease Management
Sx primary tx (only in thoracic region)
Stage I-III sx+/- neo-adj chemo and RT
Stomach Disease Management
sx
Anal canal Lymphatics and metastasis
pelvic or inguinal
50% have spread into rectum or perianal skin
M: Liver and lungs
Colorectal Mets
Peritoneal seeding
M: Liver then lungs
