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Cancer du colon : les stades d’évolution de la maladie

Le cancer peut commencer par la dégénérescence d’un polype.

Différents stades sont décrits entre le début de la transformation et l’évolution métastatique.

Le carcinome in situ

A ce stade la maladie est localisée au niveau de la muqueuse superficielle du côlon ou du rectum. Il n’y a pas d’envahissement en profondeur de la muqueuse. C’est, le plus souvent, une découverte fortuite lors de l’ablation d’un polype dont l’analyse anatomo-pathologique retrouve un foyer de carcinome in situ. Dans ce cas l’ablation du polype entraîne le traitement du cancer in situ.

La maladie localisée

La maladie est localisée à la paroi du côlon ou du rectum mais avec atteinte un peu plus profonde de la paroi sans infiltration des cellules tumorales en dehors de la paroi intestinale.

La maladie localement avancée

La maladie a dépassé les limites du côlon ou du rectum et commence à envahir les organes au voisinage : ganglions, graisse péri-vasculaire, vaisseaux sanguins…) A ce stade l’existence de métastases microscopiques (non visibles) sont probables et la mise en route d’un traitement général par chimiothérapie est recommandée.

La maladie à distance

La maladie à partir du site primitif, colique ou rectal, après évolution locale, entraîne une migration de cellules tumorales qui passent dans la circulation vasculaire et /ou lymphatique et vont se fixer sur différents organes.
Dans la maladie colique ou rectale, les sites métastatiques les plus fréquemment retrouvés sont : le foie, les poumons, le péritoine puis les os.