International preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teams.
Details
State: Public
Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_6DCB543782AF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
International preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teams.
Journal
World Journal of Surgery
Working group(s)
International Rectal Cancer Study Group (IRCSG)
Contributor(s)
Ambrosetti P., Andujar J., Baixuli J., Balen E., Baxter N., Beck D., Bemelman W., Bergamaschi R., Billingham R., Birch D., Bonardi R., Bonardi M., Bonjer J., Braga M., Buch H., Buechler M., Burnstein M., Campbell K., Caushaj P., Celebrezze J., Chang G., Cheong D., Cohen J., Colak T., Delaney C., Dhoore A., Douglas P., Dozois E., Efron J., Ellis N., Enker W., Fanelli RD., Fazio V., Fleshman J., Franklin M., Fry R., Garcia-Aguilar J., Garcia-Granero E., Habr-Gama A., Hahnloser D., Harris G., Hasegawa H., Holm T., Horgan P., Hyman N., Irwin T., Joh YG., Jongen J., Kaiser A., Kang SB., Kariv Y., Kennedy R., Kessler H., Khan M., Kim SH., Krokowicz P., Kwok S., Lacy A., Larson D., Law WL., Lee E., Lindsetmo RO., Lippert H., Ludwig K., Lynch AC., MacRae H., Madbouly K., Maeda K., Marderstein E., Marino M., Marks J., Maurer C., McLeod R., Monson J., Mortensen N., Neary P., Newstead G., OBrien D., Orangio G., Orkin B., Page M., Påhlman L., Panis Y., Panton N., Pennickx F., Phang T., Pinedo Mancilla G., Post S., Rafferty J., Rajput A., Reis Neto dos JA. J., Reynolds H., Rivadeneira D., Roselli J., Rosen H., Rossi G., Rouanet P., Rullier E., Schiedeck T., Schiessel R., Schlachta C., Schwenk W., Senagore A., Seow-Choen F., Sim R., Sing WK., Stamos M., Sternberg J., Tuckson W., Ugolini G., Vaccaro C., Vargas D., Vignali A., Vonen B., Weiss E., Wexner S., Whiteford M., Wibe A., Williams N., Woods R., Yamamoto T., Young-Fadok T.
ISSN
1432-2323 (Electronic)
ISSN-L
0364-2313
Publication state
Published
Issued date
2010
Peer-reviewed
Oui
Volume
34
Number
11
Pages
2689-2700
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
BACKGROUND: Little is known regarding variations in preoperative treatment and practice for rectal cancer (RC) on an international level, yet practice variation may result in differences in recurrence and survival rates.
METHODS: One hundred seventy-three international colorectal centers were invited to participate in a survey of preoperative management of rectal cancer.
RESULTS: One hundred twenty-three (71%) responded, with a majority of respondents from North America, Europe, and Asia. Ninety-three percent have more than 5 years' experience with rectal cancer surgery. Fifty-five percent use CT scan, 35% MRI, 29% ERUS, 12% digital rectal examination and 1% PET scan in all RC cases. Seventy-four percent consider threatened circumferential margin (CRM) an indication for neoadjuvant treatment. Ninety-two percent prefer 5-FU-based long-course neoadjuvant chemoradiation therapy (CRT). A significant difference in practice exists between the US and non-US surgeons: poor histological differentiation as an indication for CRT (25% vs. 7.0%, p = 0.008), CRT for stage II and III rectal cancer (92% vs. 43%, p = 0.0001), MRI for all RC patients (20% vs. 42%, p = 0.03), and ERUS for all RC patients (43% vs. 21%, p = 0.01). Multidisciplinary team meetings significantly influence decisions for MRI (RR = 3.62), neoadjuvant treatment (threatened CRM, RR = 5.67, stage II + III RR = 2.98), quality of pathology report (RR = 4.85), and sphincter-saving surgery (RR = 3.81).
CONCLUSIONS: There was little consensus on staging, neoadjuvant treatment, and preoperative management of rectal cancer. Regular multidisciplinary team meetings influence decisions about neoadjuvant treatment and staging methods.
METHODS: One hundred seventy-three international colorectal centers were invited to participate in a survey of preoperative management of rectal cancer.
RESULTS: One hundred twenty-three (71%) responded, with a majority of respondents from North America, Europe, and Asia. Ninety-three percent have more than 5 years' experience with rectal cancer surgery. Fifty-five percent use CT scan, 35% MRI, 29% ERUS, 12% digital rectal examination and 1% PET scan in all RC cases. Seventy-four percent consider threatened circumferential margin (CRM) an indication for neoadjuvant treatment. Ninety-two percent prefer 5-FU-based long-course neoadjuvant chemoradiation therapy (CRT). A significant difference in practice exists between the US and non-US surgeons: poor histological differentiation as an indication for CRT (25% vs. 7.0%, p = 0.008), CRT for stage II and III rectal cancer (92% vs. 43%, p = 0.0001), MRI for all RC patients (20% vs. 42%, p = 0.03), and ERUS for all RC patients (43% vs. 21%, p = 0.01). Multidisciplinary team meetings significantly influence decisions for MRI (RR = 3.62), neoadjuvant treatment (threatened CRM, RR = 5.67, stage II + III RR = 2.98), quality of pathology report (RR = 4.85), and sphincter-saving surgery (RR = 3.81).
CONCLUSIONS: There was little consensus on staging, neoadjuvant treatment, and preoperative management of rectal cancer. Regular multidisciplinary team meetings influence decisions about neoadjuvant treatment and staging methods.
Keywords
Health Care Surveys, Humans, Internationality, Neoadjuvant Therapy, Neoplasm Staging, Patient Care Team, Practice Guidelines as Topic, Preoperative Care, Rectal Neoplasms/pathology, Rectal Neoplasms/surgery, Treatment Outcome
Pubmed
Open Access
Yes
Create date
07/10/2014 15:19
Last modification date
26/01/2022 22:31
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