This selection from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Colon Cancer focuses on systemic therapy options for the treatment of metastatic colorectal cancer (mCRC), because important updates have recently been made to this section. These updates include recommendations for first-line use of checkpoint inhibitors for mCRC, that is deficient mismatch repair/microsatellite instability-high, recommendations related to the use of biosimilars, and expanded recommendations for biomarker testing. The systemic therapy recommendations now include targeted therapy options for patients with mCRC that is HER2-amplified, or BRAF V600E mutation–positive. Treatment and management of nonmetastatic or resectable/ablatable metastatic disease are discussed in the complete version of the NCCN Guidelines for Colon Cancer available at NCCN.org. Additional topics covered in the complete version include risk assessment, staging, pathology, posttreatment surveillance, and survivorship.

C. difficile colitis is a significant and increasing cause of death. Surgical treatment of C. difficile colitis has a high death rate once the fulminant expression of the disease is present.

Background Despite the significant societal burden of human papillomavirus (HPV)–associated cancers, clinical screening interventions for HPV‐associated noncervical cancers are not available. Blood‐based biomarkers may help close this gap in care. Methods Five databases were searched, 5687 articles were identified, and 3631 unique candidate titles and abstracts were independently reviewed by 2 authors; 702 articles underwent a full‐text review. Eligibility criteria included the assessment of a blood‐based biomarker within a cohort or case‐control study. Results One hundred thirty‐seven studies were included. Among all biomarkers assessed, HPV‐16 E seropositivity and circulating HPV DNA were most significantly correlated with HPV‐associated cancers in comparison with cancer‐free controls. In most scenarios, HPV‐16 E6 seropositivity varied nonsignificantly according to tumor type, specimen collection timing, and anatomic site (crude odds ratio [cOR] for p16+ or HPV+ oropharyngeal cancer [OPC], 133.10; 95% confidence interval [CI], 59.40‐298.21; cOR for HPV‐unspecified OPC, 25.41; 95% CI, 8.71‐74.06; cOR for prediagnostic HPV‐unspecified OPC, 59.00; 95% CI, 15.39‐226.25; cOR for HPV‐unspecified cervical cancer, 12.05; 95% CI, 3.23‐44.97; cOR for HPV‐unspecified anal cancer, 73.60; 95% CI, 19.68‐275.33; cOR for HPV‐unspecified penile cancer, 16.25; 95% CI, 2.83‐93.48). Circulating HPV‐16 DNA was a valid biomarker for cervical cancer (cOR, 15.72; 95% CI, 3.41‐72.57). In 3 cervical cancer case‐control studies, cases exhibited unique microRNA expression profiles in comparison with controls. Other assessed biomarker candidates were not valid. Conclusions HPV‐16 E6 antibodies and circulating HPV‐16 DNA are the most robustly analyzed and most promising blood‐based biomarkers for HPV‐associated cancers to date. Comparative validity analyses are warranted. Variations in tumor type–specific, high‐risk HPV DNA prevalence according to anatomic site and world region highlight the need for biomarkers targeting more high‐risk HPV types. Further investigation of blood‐based microRNA expression profiling appears indicated.

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Although rare, metastatic adenocarcinoma from the colon to the mandible and parotid area should be included in the differential diagnosis of masses in this area. After analysis of our case and a review of the literature, we conclude that metastasis from adenocarcinoma of the colon is quite rare and represents incurable disseminated disease.