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

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dc.contributor.authorAugestad, Knut M.
dc.contributor.authorLindsetmo, Rolv-Ole
dc.contributor.authorStulberg, Jonah
dc.contributor.authorReynolds, Harry
dc.contributor.authorSenagore, Anthony
dc.contributor.authorChampagne, Brad
dc.contributor.authorHeriot, Alexander G.
dc.contributor.authorLeblanc, Fabien
dc.contributor.authorDelaney, Conor P.
dc.contributor.authorInternational Rectal Cancer Study Group (IRCSG)
dc.contributor.authorBalén Rivera, Enrique
dc.contributor.departmentCiencias de la Saludes_ES
dc.contributor.departmentOsasun Zientziakeu
dc.date.accessioned2025-01-17T09:17:58Z
dc.date.available2025-01-17T09:17:58Z
dc.date.issued2010-08-12
dc.date.updated2025-01-17T09:11:52Z
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.en
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dc.identifier.citationAugestad, K. M., Lindsetmo, R. O., Stulberg, J., Reynolds, H., Senagore, A., Champagne, B., Heriot, A. G., Leblanc, F., Delaney, C. P., International Rectal Cancer Study Group (IRCSG) (2010). International preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teams. World Journal of Surgery, 34(11), 2689-2700. https://doi.org/10.1007/s00268-010-0738-3.
dc.identifier.doi10.1007/s00268-010-0738-3
dc.identifier.issn0364-2313
dc.identifier.urihttps://academica-e.unavarra.es/handle/2454/52976
dc.language.isoeng
dc.publisherSpringer
dc.relation.ispartofWorld Journal of Surgery (2010), vol. 34, núm. 11
dc.relation.publisherversionhttps://doi.org/10.1007/s00268-010-0738-3
dc.rights© The Author(s) 2010. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.subjectPreoperative managementen
dc.subjectRectal canceren
dc.titleInternational preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teamsen
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dspace.entity.typePublication
relation.isAuthorOfPublication9bdf0090-8a2d-4c02-ba7d-f4f59e076f61
relation.isAuthorOfPublication.latestForDiscovery9bdf0090-8a2d-4c02-ba7d-f4f59e076f61

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