Treatment of Patients With Late-Stage Colorectal Cancer: ASCO Resource-Stratified Guideline.

Autor:	Chiorean EG; University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA., Nandakumar G; Columbia Asia Hospitals, Bangalore, India.; Weill Cornell Medical College, New York, NY., Fadelu T; Dana-Farber Cancer Institute, Boston, MA., Temin S; American Society of Clinical Oncology, Alexandria, VA., Alarcon-Rozas AE; Clinica Angloamericana, Lima, Peru., Bejarano S; Excelmedica, Liga Contra el Cancer Honduras, San Pedro Sulal, Honduras., Croitoru AE; Fundeni Clinical Institute, Bucharest, Romania., Grover S; University of Pennsylvania, Philadelphia, PA., Lohar PV; HCG Cancer Center, Vadodara, Gujarat, India., Odhiambo A; University of Nairobi, College of Health Sciences, Nairobi, Kenya., Park SH; Samsung Medical Center, Seoul, South Korea., Garcia ER; Insituto Nacional De Cancerologia, Mexico City, Mexico., Teh C; Philippine Association of HPB Surgeons/Makati Medical Center, Makati City, Philippines., Rose A; Independent Colorectal Patient Representative, London, United Kingdom., Zaki B; Dartmouth-Hitchcock Medical Center, Lebanon, NH., Chamberlin MD; Dartmouth-Hitchcock Medical Center, Lebanon, NH.
Jazyk:	angličtina
Zdroj:	JCO global oncology [JCO Glob Oncol] 2020 Mar; Vol. 6, pp. 414-438.
DOI:	10.1200/JGO.19.00367
Abstrakt:	Purpose: To provide expert guidance to clinicians and policymakers in resource-constrained settings on the management of patients with late-stage colorectal cancer. Methods: ASCO convened a multidisciplinary, multinational Expert Panel that reviewed existing guidelines, conducted a modified ADAPTE process, and used a formal consensus process with additional experts for two rounds of formal ratings. Results: Existing sets of guidelines from four guideline developers were identified and reviewed; adapted recommendations from five guidelines form the evidence base and provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75% on all recommendations. Recommendations: Common elements of symptom management include addressing clinically acute situations. Diagnosis should involve the primary tumor and, in some cases, endoscopy, and staging should involve digital rectal exam and/or imaging, depending on resources available. Most patients receive treatment with chemotherapy, where chemotherapy is available. If, after a period of chemotherapy, patients become candidates for surgical resection with curative intent of both primary tumor and liver or lung metastatic lesions on the basis of evaluation in multidisciplinary tumor boards, the guidelines recommend patients undergo surgery in centers of expertise if possible. On-treatment surveillance includes a combination of taking medical history, performing physical examinations, blood work, and imaging; specifics, including frequency, depend on resource-based setting.Additional information is available at www.asco.org/resource-stratified-guidelines.
Databáze:	MEDLINE
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