Published online Apr 7, 2016. doi: 10.3748/wjg.v22.i13.3516
Peer-review started: November 12, 2015
First decision: November 27, 2015
Revised: December 4, 2015
Accepted: January 30, 2016
Article in press: January 30, 2016
Published online: April 7, 2016
Molecular advances support the existence of an alternative pathway of colorectal carcinogenesis that is based on the hypermethylation of specific DNA regions that silences tumor suppressor genes. This alternative pathway has been called the serrated pathway due to the serrated appearance of tumors in histological analysis. New classifications for colorectal cancer (CRC) were proposed recently based on genetic profiles that show four types of molecular alterations: BRAF gene mutations, KRAS gene mutations, microsatellite instability, and hypermethylation of CpG islands. This review summarizes what is known about the serrated pathway of CRC, including CRC molecular and clinical features, prognosis, and response to chemotherapy.
Core tip: Recently, the implication among colorectal cancers with methylator phenotype has burst into the gastroenterology literature. In this review, we analyze the correlation between serrated cancers, the methylator phenotype and other genetic features in order to assess their prognosis and response to adjuvant chemotherapy.