C E L Klaver1, H Groenen1, D G Morton2, S Laurberg3, W A Bemelman1, P J Tanis1. 1. Department of Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. 2. Academic Department of Surgery, University of Birmingham, Edgbaston, Birmingham, UK. 3. Department of Surgical Gastroenterology, Aarhus University, Aarhus C, Denmark.
Abstract
AIM: This systematic review aimed to provide an overview of (inter)national guidelines on the treatment of peritoneal metastases of colorectal cancer origin (PMCRC) and to determine the degree of consensus and available evidence with identification of topics for future research. METHOD: A systematic search of MEDLINE, Embase, PubMed as well as Tripdatabase, National Guideline Clearinghouse, BMJ Best Practice and Guidelines International Network was performed to identify (inter)national guidelines and consensus statements from oncological or surgical societies on PMCRC. The quality of guidelines was assessed using the AGREE-II score. Topics followed by recommendations were extracted from the guidelines. The recommendations, highest level of supporting evidence and the degree of consensus were determined for each topic. RESULTS: Twenty-one guidelines were included, in most (15) of which cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) was recommended in selected patients based on level 1b evidence. Substantial consensus was also reached on the benefit of multidisciplinary team discussion and the achievability of a (near) complete cytoreduction (CC0-1) without supporting evidence. Both evidence and consensus were lacking regarding other aspects including preoperative positron emission tomography/CT, second look surgery in high risk patients, the optimal patient selection for CRS/HIPEC, procedural aspects of HIPEC and (perioperative) systemic therapy. CONCLUSION: In currently available guidelines, evidence and consensus on the treatment strategy for PMCRC are lacking. Updates of guidelines are ongoing and future (randomized) clinical trials should contribute to multidisciplinary and international consensus on treatment strategies for PMCRC. Colorectal Disease
AIM: This systematic review aimed to provide an overview of (inter)national guidelines on the treatment of peritoneal metastases of colorectal cancer origin (PMCRC) and to determine the degree of consensus and available evidence with identification of topics for future research. METHOD: A systematic search of MEDLINE, Embase, PubMed as well as Tripdatabase, National Guideline Clearinghouse, BMJ Best Practice and Guidelines International Network was performed to identify (inter)national guidelines and consensus statements from oncological or surgical societies on PMCRC. The quality of guidelines was assessed using the AGREE-II score. Topics followed by recommendations were extracted from the guidelines. The recommendations, highest level of supporting evidence and the degree of consensus were determined for each topic. RESULTS: Twenty-one guidelines were included, in most (15) of which cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) was recommended in selected patients based on level 1b evidence. Substantial consensus was also reached on the benefit of multidisciplinary team discussion and the achievability of a (near) complete cytoreduction (CC0-1) without supporting evidence. Both evidence and consensus were lacking regarding other aspects including preoperative positron emission tomography/CT, second look surgery in high risk patients, the optimal patient selection for CRS/HIPEC, procedural aspects of HIPEC and (perioperative) systemic therapy. CONCLUSION: In currently available guidelines, evidence and consensus on the treatment strategy for PMCRC are lacking. Updates of guidelines are ongoing and future (randomized) clinical trials should contribute to multidisciplinary and international consensus on treatment strategies for PMCRC. Colorectal Disease
Authors: Marco Tonello; Dario Baratti; Paolo Sammartino; Andrea Di Giorgio; Manuela Robella; Cinzia Sassaroli; Massimo Framarini; Mario Valle; Antonio Macrì; Luigina Graziosi; Federico Coccolini; Piero Vincenzo Lippolis; Roberta Gelmini; Marcello Deraco; Daniele Biacchi; Francesco Santullo; Marco Vaira; Katia Di Lauro; Fabrizio D'Acapito; Fabio Carboni; Giuseppe Giuffrè; Annibale Donini; Paola Fugazzola; Pinuccia Faviana; Lorena Sorrentino; Antonio Scapinello; Paola Del Bianco; Antonio Sommariva Journal: Ann Surg Oncol Date: 2021-11-16 Impact factor: 5.344
Authors: Koen P Rovers; Checca Bakkers; Felice N van Erning; Jacobus W A Burger; Simon W Nienhuijs; Geert A A M Simkens; Geert-Jan M Creemers; Patrick H J Hemmer; Cornelis J A Punt; Valery E P P Lemmens; Pieter J Tanis; Ignace H J T de Hingh Journal: JAMA Oncol Date: 2020-08-13 Impact factor: 31.777
Authors: Koen P Rovers; Checca Bakkers; Geert A A M Simkens; Jacobus W A Burger; Simon W Nienhuijs; Geert-Jan M Creemers; Anna M J Thijs; Alexandra R M Brandt-Kerkhof; Eva V E Madsen; Ninos Ayez; Nadine L de Boer; Esther van Meerten; Jurriaan B Tuynman; Miranda Kusters; Nina R Sluiter; Henk M W Verheul; Hans J van der Vliet; Marinus J Wiezer; Djamila Boerma; Emma C E Wassenaar; Maartje Los; Cornelis B Hunting; Arend G J Aalbers; Niels F M Kok; Koert F D Kuhlmann; Henk Boot; Myriam Chalabi; Schelto Kruijff; Lukas B Been; Robert J van Ginkel; Derk Jan A de Groot; Rudolf S N Fehrmann; Johannes H W de Wilt; Andreas J A Bremers; Philip R de Reuver; Sandra A Radema; Karin H Herbschleb; Wilhelmina M U van Grevenstein; Arjen J Witkamp; Miriam Koopman; Nadia Haj Mohammad; Eino B van Duyn; Walter J B Mastboom; Leonie J M Mekenkamp; Joost Nederend; Max J Lahaye; Petur Snaebjornsson; Cornelis Verhoef; Hanneke W M van Laarhoven; Aeilko H Zwinderman; Jeanette M Bouma; Onno Kranenburg; Iris van 't Erve; Remond J A Fijneman; Marcel G W Dijkgraaf; Patrick H J Hemmer; Cornelis J A Punt; Pieter J Tanis; Ignace H J T de Hingh Journal: BMC Cancer Date: 2019-04-25 Impact factor: 4.430