Colorectal Cancer

Colorectal canceris one of the most common cancers worldwide and also one of the leading causes of cancer-related deaths in developed countries. Globally, it is the third most common malignant tumor (excluding skin cancers), and in Europe, it is actually the most common cancer (again, excluding skin cancers). 

The Czech Republic also has a high incidence of colorectal cancer, consistently ranking among the highest in international statistics when compared to other countries. Every year, more than 8,400 people in the Czech Republic undergo surgery for this condition. During the same period, 4,000 people die from the disease. Colorectal cancer thus contributes significantly to the overall burden of cancer on the Czech population. Another serious fact is that although this is a disease of older age (the average age of a Czech patient with colorectal cancer is 67), it also affects many people of working age, and a full 21% of patients are diagnosed before the age of 60. 

Doctors from various specialties are involved in the diagnosis and treatment of colorectal cancer—inscreening(detecting early stages of the disease), these include general practitioners, outpatient surgeons, and gastroenterologists; in treatment, they include surgeons, endoscopists, oncologists, and radiation oncologists. Their well-coordinated collaboration is aimed at maximizing patient benefit. It follows from the above that the diagnosis and treatment of cancer is multidisciplinary, meaning that it involves multiple medical specialties (gastroenterologist, oncologist, surgeon, radiologist, pathologist, etc.), who always assess each case individually and propose the most appropriate treatment plan for the patient. That is why our department has a specialized team dedicated specifically tothe diagnosis and treatment of colorectal cancer.  

Our hospital’s endoscopy unit, which is designated asa colorectalcancerscreening center, isan important partner to our department in both the diagnosis and treatment of this disease.  

As part of a multidisciplinary oncology team, we collaborate with the Department of Oncology at the First Faculty of Medicine of Charles University and the General University Hospital in Prague (VFN).   

Surgical treatment of colorectal cancercan be divided, based on the surgical approach, into minimally invasive (laparoscopic or robotic) and open (incision-based) procedures. Clearly defined oncological criteria apply to all parts of the colon and rectum, and these must be adhered to (removal of lymph nodes and surrounding fatty tissue, ligation of feeding vessels at a sufficient distance from the cancer, sufficient distance of the tumor from the resection margins, etc.).

Minimally invasive procedures (laparoscopic or robotic) offer patients numerous benefits. They speed up recovery, facilitate a quicker return to normal life, and significantly reduce postoperative pain. Short, inconspicuous, cosmetically acceptable scars in the lower abdomen also play a significant role for active patients. Last but not least, postoperative hernias develop in these short scars only in a negligible number of cases. All of this contributes to a faster start of postoperative oncological treatment, if necessary in a given case.

Our department is equipped with two new laparoscopic systems that meet these criteria, as well as a team of physicians who specialize in this field.

As part of a multidisciplinary oncology team, we collaborate with the Department of Oncology at the First Faculty of Medicine of Charles University and the General University Hospital in Prague (VFN). Each oncology patient is individually assessed by the multidisciplinary oncology team, and treatment is tailored to their specific needs (patient-tailored approach).

Diseases of the rectum differ somewhat from those affecting the upper parts of the colon. In these cases, it is often necessary to first begin preoperative radiation therapy for the tumor, combined with chemotherapy. The surgery itself is scheduled several weeks after the completion of the initial treatment. Once again, the specific course of treatment is determined by the oncology team.  

Last year, nearly 65% of the surgeries for colorectal cancer performed at our facility were laparoscopic.  

In the field of rectal cancer, our department has long been among the leaders in the Czech Republic in terms of the number of laparoscopic, so-called sphincter-preserving surgeries performed, with a standardized 90-day mortality rate of at least 90%. (Source: Quality Indicators Portal – Health Insurance Office – https://puk.kancelarzp.cz/) 

This year saw a further increase in both the total number of patients undergoing surgery for colorectal cancer and the number of laparoscopic procedures performed for this condition (75%).