A Study of Imaging, Blood, and Tissue Samples to Guide Treatment of Colon Cancer and Related Liver Tumors
A Study of Imaging, Blood, and Tissue Samples to Guide Treatment of Colon Cancer and Related Liver Tumors
The purpose of this study is to explore novel ways of diagnosing colon cancer and predicting
 its propensity to spread to other organs such as the liver.
Inclusion Criteria:

 -  Patients must be undergoing one of the following procedures as part of their routine
 care in order to meet the inclusion criteria:

 -  Operation for presumed stage I-IV colon cancer including colectomy, hepatectomy,
 or abdominal surgery (e.g. insertion of HAIP)

 -  Colectomy for presumed benign or pre-malignant colon tumors (e.g. large
 nonneoplastic polyps or adenomas)

 -  Open, laparoscopic, or robotic resections

 -  ≥18 years old

 Exclusion Criteria:

 -  Extrahepatic CRC metastasis

 -  No preoperative portal venous phase CT scan performed up to two months prior to day of
 surgery Pathology demonstrating a malignant tumor other than colorectal
 adenocarcinoma.

 -  Stage IV colon cancer with resectable hepatic disease undergoing hepatectomy with
 active primary colon tumor still in place (despite chemo-radiation therapy) and no
 plans for colectomy.

 -  Receipt of experimental therapies for colon cancer (e.g. checkpoint inhibitors or
 novel targeted agents). Of note, approved targeted agents (such as anti-angiogenic
 agents, EGFR inhibitors etc) are not an exclusion criterion.

 -  History of non-colonic malignancy w/in 5 years (except non-melanomatous skin cancer)

 -  Colon cancer with microsatellite instability (MSI-high) if known preoperatively

 -  Known hereditary colon cancer syndrome such as familial adenomatous polyposis (FAP) or
 hereditary nonpolyposis colorectal cancer (HNPCC)

 -  Known liver disease (e.g. non-alcoholic steatohepatitis, cirrhosis, viral or other
 form of hepatitis, etc)

 -  INR >2 or known clotting factor deficiency

 -  Anticipated need for full anticoagulation during hospitalization

 -  Receipt of medications that increase significantly the risk of bleeding after liver
 biopsy (at the surgeon"s discretion)

 -  Intraoperative discovery of pathology that precludes the planned surgical resection or
 liver biopsy, or makes resection futile (such as peritoneal carcinomatosis or other
 extrahepatic metastatic disease)

 -  Operating surgeon deems research interventions to be more than a minimal risk for the
 patient