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Article: International preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teams

TitleInternational preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teams
Authors
Issue Date2010
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
World Journal of Surgery, 2010, v. 374 n. 11, p. 2689-2700 How to Cite?
AbstractBACKGROUND: 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.
DescriptionLaw, WL is one of the members of the International Rectal Cancer Study Group
Persistent Identifierhttp://hdl.handle.net/10722/139748
ISSN
2015 Impact Factor: 2.523
2015 SCImago Journal Rankings: 1.375
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorAuggestad, KMen_US
dc.contributor.authorLindsetmo, ROen_US
dc.contributor.authorStulberg, Jen_US
dc.contributor.authorReynolds, Hen_US
dc.contributor.authorSenagore, Aen_US
dc.contributor.authorChampagne, Ben_US
dc.contributor.authorHeriot, AGen_US
dc.contributor.authorLeblanc, Fen_US
dc.contributor.authorDelaney, CPen_US
dc.contributor.authorInternational Rectal Cancer Study Groupen_US
dc.contributor.authorLaw, WLen_US
dc.date.accessioned2011-09-23T05:55:12Z-
dc.date.available2011-09-23T05:55:12Z-
dc.date.issued2010en_US
dc.identifier.citationWorld Journal of Surgery, 2010, v. 374 n. 11, p. 2689-2700en_US
dc.identifier.issn0364-2313-
dc.identifier.urihttp://hdl.handle.net/10722/139748-
dc.descriptionLaw, WL is one of the members of the International Rectal Cancer Study Group-
dc.description.abstractBACKGROUND: 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.-
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/-
dc.relation.ispartofWorld Journal of Surgeryen_US
dc.rightsThe original publication is available at www.springerlink.com-
dc.subject.meshHealth Care Surveys-
dc.subject.meshInternationality-
dc.subject.meshNeoadjuvant Therapy-
dc.subject.meshPatient Care Team-
dc.subject.meshRectal Neoplasms - pathology - surgery - therapy-
dc.titleInternational preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teamsen_US
dc.typeArticleen_US
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0364-2313&volume=374&issue=11&spage=2689&epage=2700&date=2010&atitle=International+preoperative+rectal+cancer+management:+staging,+neoadjuvant+treatment,+and+impact+of+multidisciplinary+teams-
dc.identifier.emailDelaney, CP: conor.delaney@UHhospitals.orgen_US
dc.identifier.emailInternational Rectal Cancer Study Group, : IRCSGen_US
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hk-
dc.identifier.authorityLaw, WL=rp00436en_US
dc.description.naturepublished_or_final_versionen_US
dc.identifier.doi10.1007/s00268-010-0738-3-
dc.identifier.pmid20703471-
dc.identifier.pmcidPMC2949570-
dc.identifier.scopuseid_2-s2.0-79952653729-
dc.identifier.hkuros192497en_US
dc.identifier.volume374en_US
dc.identifier.issue11en_US
dc.identifier.spage2689en_US
dc.identifier.epage2700en_US
dc.identifier.isiWOS:000282506500027-
dc.identifier.citeulike7764189-

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