Organ preservation in rectal cancer: a synopsis of current guidelines.

Details

Serval ID
serval:BIB_E7F9174BDE18
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Organ preservation in rectal cancer: a synopsis of current guidelines.
Journal
Colorectal disease
Author(s)
Borstlap WAA, van Oostendorp S.E., Klaver CEL, Hahnloser D., Cunningham C., Rullier E., Bemelman W.A., Tuynman J.B., Tanis P.J.
Working group(s)
research committee of the European Society of Coloproctology.
ISSN
1463-1318 (Electronic)
ISSN-L
1462-8910
Publication state
Published
Issued date
14/11/2017
Peer-reviewed
Oui
Volume
20
Number
3
Pages
201-210
Language
english
Notes
Publication types: Journal Article

Abstract
The high morbidity associated with radical resection for rectal cancer is an incentive for surgeons to adopt strategies aimed at organ preservation, particularly for early disease. There are a number of different approaches to achieve this. In this study we have collated current national and international guidelines to produce a synopsis to support this changing practice.
The databases PubMed, Embase, Trip database, national guideline clearinghouse, BMJ Best practice were interrogated. Guidelines published before 2010 were excluded. The AGREE-II tool was used for quality assessment.
24 guidelines were drawn from 2278 potential publications. A consensus exists for local excision for "low risk" T1 rectal cancer but there is no agreement how to stratify the risk of treatment failure. There is a low level of agreement for rectal preservation for more advanced disease but when mentioned is recommended for unfit patients or in th context of a clinical trial. Guidelines are inconsistent with respect to surveillance in node negative disease and after, complete response to chemoradiotherapy CONCLUSION: According to current guidelines and consensus statements organ preservation for rectal cancer beyond low risk T1, is still considered experimental and only indicated in patients unsuitable for radical surgery.. Follow up strategies and cN0 staging deserve attention and highlight the need for high quality clinical trials. This article is protected by copyright. All rights reserved.

Pubmed
Web of science
Create date
16/11/2017 21:45
Last modification date
20/08/2019 17:10
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