Diretrizes para diagnóstico, estadiamento e tratamento cirúrgico e multidisciplinar do câncer colorretal

Cordeiro, Fernando

doi:10.1590/s0104-42302004000100017

Cited by 7 publications

(15 citation statements)

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“…CRC is a curable disease if diagnosed in early stages [6]. However, between 70 and 90% of CRC cases are currently diagnosed in advanced stages of the disease, resulting in initiatives including biomarkers to help identify patients earlier [5–8].…”

Section: Introductionmentioning

confidence: 99%

“…The use of molecular biological agents, monoclonal antibodies (MoAbs), in combination with 5-FU/oxaliplatin or irinotecan has become widespread to try and improve survival rates in patients with mCRC [6, 12–15]. However, the biological medicines have appreciably increased the cost of medicines with the high costs of MoAbs, often with limited health gain versus current standards.…”

Section: Introductionmentioning

confidence: 99%

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Comparative Effectiveness and Safety of Monoclonal Antibodies (Bevacizumab, Cetuximab, and Panitumumab) in Combination with Chemotherapy for Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis

Silva

Araújo

Lima³

et al. 2018

BioDrugs

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BackgroundThe last decade has seen the increasing use of biological medicines in combination with chemotherapy containing 5-fluorouracil/oxaliplatin or irinotecan for the treatment of metastatic colorectal cancer (mCRC). These combinations have resulted in increased progression-free survival (PFS) in patients with mCRC; however, there are remaining concerns over the extent of their effect on overall survival (OS). Published studies to date suggest no major differences between the three currently available monoclonal antibodies (MoAbs); however, there are differences in costs. In addition, there is rising litigation in Brazil in order to access these medicines as they are currently not reimbursed.ObjectiveThe aim was to investigate the comparative effectiveness and safety of three MoAbs (bevacizumab, cetuximab and panitumumab) associated with fluoropyrimidine-based chemotherapy regimens and compared to fluoropyrimidine-based chemotherapy alone in patients with mCRC, through an updated systematic review and meta-analysis of concurrent or non-concurrent observational cohort studies, to guide authorities and the judiciary.MethodA systematic review and meta-analysis was performed based on cohort studies published in databases up to November 2017. Effectiveness measures included OS, PFS, post-progression survival (PPS), Response Evaluation Criteria In Solid Tumors (RECIST), response rate, metastasectomy and safety. The methodological quality of the studies was also evaluated.ResultsA total of 21 observational cohort studies were included. There were statistically significant and clinically relevant benefits in patients treated with bevacizumab versus no bevacizumab mainly around OS, PFS, PPS and the metastasectomy rate, but not for the disease control rates. However, there was an increase in treatment-related toxicities and concerns with the heterogeneity of the studies.ConclusionThe results pointed to an advantage in favor of bevacizumab for OS, PFS, PPS, and metastasectomy. Although this advantage may be considered clinically modest, bevacizumab represents a hope for increased survival and a chance of metastasectomy for patients with mCRC. However, there are serious adverse events associated with its use, especially severe hypertension and gastrointestinal perforation, that need to be considered.Electronic supplementary materialThe online version of this article (10.1007/s40259-018-0322-1) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative Effectiveness and Safety of Monoclonal Antibodies (Bevacizumab, Cetuximab, and Panitumumab) in Combination with Chemotherapy for Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis

Silva

Araújo

Lima³

et al. 2018

BioDrugs

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“…Radiological examination has relevance and evidences for preoperative staging with investigation of possible metastases (intra-abdominal, pelvic and pulmonary metastases), tumor infiltration or extension, and postoperative evaluations together with anatomopathological staging 1 , 10 , 11 , 15 , 17 , 25 , 26 , 28 .…”

Section: Introductionmentioning

confidence: 99%

Pre- And Postoperative Imaging Methods in Colorectal Cancer

Souza

Cuenca

et al. 2018

ABCD, arq. bras. cir. dig.

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Introduction: Among the screening tests for colorectal cancer, colonoscopy is currently considered the most sensitive and specific technique. However, computed tomography colonography (CTC), magnetic resonance imaging (MRI), and transrectal ultrasonography have gained significant ground in the clinical practice of pre-treatment, screening and, more recently, post-treatment and surgical evaluation. Objective: To demonstrate the high accuracy of CT and MRI for pre and postoperative colorectal cancer staging. Methods: Search and analysis of articles in Pubmed, Scielo, Capes Periodicals and American College of Radiology with headings “colorectal cancer” and “colonography”. Weew selected 30 articles that contained radiological descriptions, management or statistical data related to this type of neoplasia. The criteria for radiological diagnosis were the American College of Radiology. Results : The great majority of patients with this subgroup of neoplasia is submitted to surgical procedures with the objective of cure or relief, except those with clinical contraindication. CTC colonography is not the most commonly used technique for screening; however, it is widely used for treatment planning, assessment of the abdomen for local complications or presence of metastasis, and post-surgical evaluation. MRI colonography is an alternative diagnostic method to CT, recommended by the American Society of Gastrointestinal Endoscopy. Although there are still no major studies on the use of MRI for screening, the high resolution examination has now shown good results for the American Joint Committee on Cancer TNM classification. Conclusion: MRI and CT represent the best means for colorectal neoplasm staging. The use of these methods as screening tools becomes beneficial to decrease complications and discomfort related to colonoscopy.

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“…Há intenção curativa quando se promove a remoção completa do tumor primário, ór-gãos ou estruturas adjacentes comprometidos, com margem circunferencial e radial histologicamente livres (ressecção em bloco). Tratamento radio e quimioterápicos podem apresentar vantagens nos estádios II e III (3); (14) .Os quadros 4 e 5 apresentam as diretrizes do National Cancer Institute -U.S. National Institutes of Health para tratamento do CCR.…”

Section: Introductionunclassified

Câncer colorretal sincrônico: relato de caso e revisão de literatura

Andrade

Pereira

2007

Rev bras. colo-proctol.

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RESUMO: Relatamos o caso de uma paciente com tumor maligno em cólon direito e neoplasia sincrônica de reto. Os objetivos deste estudo são discutir as vantagens da colonoscopia na detecção de tumores sincrônicos e avaliar os fatores prognósticos mais relevantes na sobrevida de doentes com câncer colorretal (CCR). Utilizamos como fonte de pesquisa, a coleta de dados em prontuário e busca em base de dados do Medline, Lilacs e Scielo. Concluímos que: 1) A colonoscopia oferece avaliação completa do cólon, com diagnóstico pré-operatório de tumores sincrônicos, o que muitas vezes interfere na conduta terapêutica e 2) Os fatores que mais interferem a sobrevida de pacientes com CCR são o estágio de Dukes, grau de diferenciação do tumor e extensão da ressecção cirúrgica.

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Diretrizes para diagnóstico, estadiamento e tratamento cirúrgico e multidisciplinar do câncer colorretal

Cited by 7 publications

References 0 publications

Comparative Effectiveness and Safety of Monoclonal Antibodies (Bevacizumab, Cetuximab, and Panitumumab) in Combination with Chemotherapy for Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis

Comparative Effectiveness and Safety of Monoclonal Antibodies (Bevacizumab, Cetuximab, and Panitumumab) in Combination with Chemotherapy for Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis

Pre- And Postoperative Imaging Methods in Colorectal Cancer

Câncer colorretal sincrônico: relato de caso e revisão de literatura

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