**Author details**

*Multidisciplinary Approach for Colorectal Cancer*

**7. Conclusions**

development is still uncertain.

The authors have no conflict of interest.

**Conflict of interest**

and carcinogenesis, and support colonic barrier function [44].

protected from colon cancer and other inflammatory diseases.

Butyrate is the preferred substrate of colonocytes [43]. This compost was incredibly studied due to its capacity to reduce oxidative stress, diminish inflammation

The diet can shape the colonic microbiota and their function, and, on the other hand, the microbiota influences the health of the intestine. This way the host is

CRC is the third most commonly diagnosed malignancy and the fourth leading cause of cancer death in the world. There are five CMS of CRC: the MSI-immune, the canonical subtype, the metabolic subtype, and the last subtype with mixed features. The strength of the in situ adaptive immune reaction is strongly correlated with time to recurrence and overall survival of CRC which leads us to think that the immune system plays an important role in CRC development. The consensus Immunoscore is a scoring system that outlines the density of CD3+ and CD8+ T-cell effectors existent in the tumor and its invasive margin, and the authors believe that this score could be a good prognostic marker. On the other hand, the dysbiosis could be combined with Immunoscore to increase the power of the biomarker. Studies about this interaction are needed. The role of microbiota in colorectal cancer is complex: its disturbance is the cause of tumorigenesis, or the outcome of tumor

**72**

Filipa Macedo1 , Nuno Bonito1 , Adhemar Longatto-Filho2,3,4,5 and Sandra F. Martins2,3,6\*

1 Portuguese Oncology Institute, Coimbra, Portugal

2 Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal

3 ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Braga, Portugal

4 Molecular Oncology Research Center, Barretos, São Paulo, Brazil

5 Laboratory of Medical Investigation (LIM) 14, Faculty of Medicine, University of Sao Paulo, Brazil

6 Surgery Department, Coloproctology Unit, Braga Hospital, Braga, Portugal

\*Address all correspondence to: sandramartins@med.uminho.pt

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
