Recent progress in pathogenesis and management of colorectal cancer. Eighteenth International Symposium of the Hiroshima Cancer Seminar, November 2008

This symposium presented recent progress of the pathogenesis and treatment of colorectal cancer (CRC). Field cancerization by modified stem cells may be the earliest changes associated with CRC. CD34 + ‐immature myeloid cells are deeply involved in CRC invasion. Inflammatory mediators stimulate cancer progression. We must strive for a better understanding of the molecular mechanisms responsible for this connection. Serial analysis of gene expression data analysis has identified novel biomarkers for cancer detection and possible prognosis. Better endoscopic techniques are suitable for early detection and resection of colonic lesions. Chemoprevention of CRC using sulindac and aberrant crypt foci as a clinical endpoint have shown glutathione S‐transferase π as a possible new target. A new drug delivery system using nanoparticles is being developed with SN‐38, a biologically active metabolite of irinotecan. Survival of Japanese male patients with CRC is the best in the world due to lymph node dissection and surveillance. The use of laparoscopic surgery has increased, especially for advanced cancer. A treatment trial by the Sanin Study Group suggests that modified 5‐fluorouracil and leucovorin with oxaliplatin treatment could be carried out in elderly patients. A great deal of information for understanding carcinogenesis and treatment has provided us with novel strategies for the management and prevention of CRC. ( Cancer Sci 2009; 100: 978–981)