Delphi initiative for early-onset colorectal cancer (DIRECt). International Management Guidelines

Autor: Cavestro Giulia, M, Mannucci, A, Balaguer, F, Hampel, H, Kupfer, SS, Repici, A, Sartore-Bianchi, A, Seppälä Toni, T, Valentini, V, Boland Clement, R, Brand, RE, Buffart, TE, Burke, CA, Caccialanza, R, Cannizzaro, R, Cascinu, S, Cercek, A, Crosbie, EJ, Danese, S, Dekker, E, Daca-Alvarez, M, Deni, F, Dominguez-Valentin, M, Eng, C, Goel, A, Guillem Josè, G, Houwen, B, Kahi, C, Kalady, MF, Kastrinos, F, Kühn, F, Laghi, L, Latchford, A, Liska, D, Lynch, P, Malesci, A, Mauri, G, Meldolesi, E, Møller, P, Monahan, KJ, Moslein, G, Murphy, CC, Nass, K, Ng, K, Oliani, C, Papaleo, E, Patel, SG, Puzzono, M, Remo, A, Ricciardiello, L, Ripamonti Carla, I, Siena, S, Singh, SK, Stadler, ZK, Stanich, PP, Syngal, S, Turi, S, Urso Emanuele, D, Valle, L, Vanni Valeria, S, Vilar, E, Vitellaro, M, You, Y-QN, Yurgelun, MB, Zuppardo Raffaella, A, Stoffel, EM, Associazione Italiana Familiarità Ereditarietà Tumori, Collaborative Group of the Americas on Inherited Gastrointestinal Cancers, European Hereditary Tumor Group, International Society for Gastrointestinal Hereditary Tumours
Přispěvatelé: Tampere University, Clinical Medicine, Department of Gastroenterology, Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, Internal medicine
Rok vydání: 2022
Předmět:
Zdroj: 603.E33
Clinical gastroenterology and hepatology, 21(3), 581-603.e33. W.B. Saunders Ltd
Associazione Italiana Familiarit? Ereditariet? Tumori, Collaborative Group of the Americas on Inherited Gastrointestinal Cancer & European Hereditary Tumour Group, and the International Society for Gastrointestinal Hereditary Tumours 2023, ' Delphi Initiative for Early-Onset Colorectal Cancer (DIRECt) International Management Guidelines ', Clinical Gastroenterology and Hepatology, vol. 21, no. 3, pp. 581-603.e33 . https://doi.org/10.1016/j.cgh.2022.12.006
Clinical Gastroenterology and Hepatology, 21(3), 581-603.e33. W.B. Saunders Ltd
ISSN: 1542-7714
1542-3565
DOI: 10.1016/j.cgh.2022.12.006
Popis: BACKGROUND & AIMS: Patients with early-onset colorectal cancer (eoCRC) are managed according to guidelines that are not age-specific. A multidisciplinary international group (DIRECt), composed of 69 experts, was convened to develop the first evidence-based consensus recommendations for eoCRC. METHODS: After reviewing the published literature, a Delphi methodology was used to draft and respond to clinically relevant questions. Each statement underwent 3 rounds of voting and reached a consensus level of agreement of ≥80%. RESULTS: The DIRECt group produced 31 statements in 7 areas of interest: diagnosis, risk factors, genetics, pathology-oncology, endoscopy, therapy, and supportive care. There was strong consensus that all individuals younger than 50 should undergo CRC risk stratification and prompt symptom assessment. All newly diagnosed eoCRC patients should receive germline genetic testing, ideally before surgery. On the basis of current evidence, endoscopic, surgical, and oncologic treatment of eoCRC should not differ from later-onset CRC, except for individuals with pathogenic or likely pathogenic germline variants. The evidence on chemotherapy is not sufficient to recommend changes to established therapeutic protocols. Fertility preservation and sexual health are important to address in eoCRC survivors. The DIRECt group highlighted areas with knowledge gaps that should be prioritized in future research efforts, including age at first screening for the general population, use of fecal immunochemical tests, chemotherapy, endoscopic therapy, and post-treatment surveillance for eoCRC patients. CONCLUSIONS: The DIRECt group produced the first consensus recommendations on eoCRC. All statements should be considered together with the accompanying comments and literature reviews. We highlighted areas where research should be prioritized. These guidelines represent a useful tool for clinicians caring for patients with eoCRC. publishedVersion
Databáze: OpenAIRE
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