Disease Progression and Therapy-Induced Changes in Metastatic Colorectal Cancer

Abstract

Colon cancer is the fourth most common form of cancer worldwide. It is a major cause of cancer-related mortality with around 700,000 deaths annually worldwide. The prognosis of colorectal cancer patients is largely determined by the presence of metastases, mainly in the liver. If untreated, the mean survival of patients with liver metastases in liver <1 year and the 5-year survival is only 13%. This makes colon cancer or metastatic colon cancer one of the most deadly diseases worldwide. Surgery is currently the first choice of treatment for colon cancer. However, not only surgery, but also other treatments can affect tumor cell characteristics and tumor growth. This thesis investigated disease progression and the therapy-induced changes in tumors of patients with metastatic colorectal cancer. Specific tumor properties can be identified that could lead us to new (adjuvant) treatments. Additional strategies can also be developed that reduce the return of cancer after surgery. Ultimately, recommendations can be made to improve survival in this group of patients. This will ultimately result in improved personalized cancer care and increased life expectancy in patients with metastatic colorectal cancer.