Eastern Canadian Gastrointestinal Cancer Consensus Conference 2019

Abstract

The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2019 was held in Morell, Prince Edward Island, 19–21 September 2019. Experts in medical oncology, radiation oncology, and surgical oncology who are involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics in the management of anal, colorectal, biliary tract, and gastric cancers, including: radiotherapy and systemic therapy for localized and advanced anal cancer; watch and wait strategy for the management of rectal cancer; role of testing for dihydropyrimidine dehydrogenase (DPD) deficiency prior to commencement of fluoropyrimidine therapy; radiotherapy and systemic therapy in the adjuvant and unresectable settings for biliary tract cancer; and radiotherapy and systemic therapy in the perioperative setting for early-stage gastric cancer.

Guidance documents for colorectal and anal cancer treatment: A systematic quality and reporting assessment

“…After filtering through reviews of titles and abstracts, 63 records were appraised for eligibility. Finally, 59 guidelines were included (45 CPGs [30–88] and 14 CSs [42, 44–46, 49, 56–58, 67, 75, 80, 83, 86, 88]) for the final full‐text appraisal (Table 1). Seven CPGs and no CSs (11.9%) were in French [37–40], Slovenian [77], Norwegian [68] and Croatian [82]; a total of 52/59 (88.1%) documents were in English.…”

The Effect of Coronavirus Disease 2019 on the Quality of Associated Care in Patients with Gastric Cancer

“…Patients with GC bleeding or gastric outlet obstruction who were unable to undergo endoscopic/interventional radiology were selected for surgery. 60 …”

A Systematised Literature Review of Real-World Treatment Patterns and Outcomes in Unresectable Advanced or Metastatic Biliary Tract Cancer

“…Multiple lines of systemic chemotherapy were cautioned against by two guidelines [66,67], one guideline mentioned the use of FP-based systemic chemotherapy, noting a lack of evidence of benefit [68]. Guidelines further recommended enrolment in clinical trials [3,66,69], and the use of targeted therapies in biomarker-defined populations [3,67] (Table S13 of the ESM).…”

“…Because the intent of treatment for unresectable advanced or metastatic BTC is not curative, all management of unresectable advanced or metastatic BTC could be considered palliative, including the 1-3L treatments described previously. Guidelines included a range of options as palliative treatments, including various non-chemotherapy-based treatments without a clear designation of a treatment line [66,67,69,[74][75][76][77][78][79][80][81][82] as well as treatments termed here as 'non-active treatments' such as stenting and biliary drainage [3,66,67,74,79,83]. However, BTC treatment guidelines mentioned the paucity of evidence of clear benefit for such treatments and did not make clear recommendations for treatment algorithm and appropriate patient populations.…”