Rectal Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology

Benson, Al B.; Venook, Alan P.; Al-Hawary, Mahmoud M.; Azad, Nilofer A.; Chen, Yi Jen; Ciombor, Kristen K.; Cohen, Stacey A.; Cooper, Harry S.; Deming, Dustin A.; Garrido‐Laguna, Ignacio; Grem, Jean L.; Gunn, Andrew J.; Hecht, J. Randolph; Hoffe, Sarah E.; Hubbard, Joleen M.; Hunt, Steven R.; Jeck, William R.; Johung, Kimberly L.; Kirilcuk, Natalie; Krishnamurthi, Smitha; Maratt, Jennifer K.; Messersmith, Wells A.; Meyerhardt, Jeffrey A.; Miller, Eric D.; Mulcahy, Mary F.; Nurkin, Steven; Overman, Michael J.; Parikh, Aparna; Patel, Hitendra; Pedersen, Katrina; Saltz, Leonard B.; Schneider, Charles J.; Shibata, David; Skibber, John M.; Sofocleous, Constantinos T.; Stotsky-Himelfarb, Eden; Tavakkoli, Anna; Willett, Christopher G.; Gregory, Kristina M.; Gurski, Lisa A.

doi:10.6004/jnccn.2022.0051

Cited by 331 publications

(225 citation statements)

References 251 publications

(331 reference statements)

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“…On the authority of the NCCN guidelines 35 , colorectal cancer patients who are clinically diagnosed as T3…”

Section: Discussionmentioning

confidence: 99%

Is it safe to perform Enterectomy in colorectal cancer patients aged 80 or older? A meta-analysis and a systematic review

Chen

et al. 2023

Preprint

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Background Colorectal cancer is one of the four most common cancers in the world. At present, Human beings have stepped into an aging society, and the number of over eighties colorectal cancer patients has increased year by year. However, few high-quality studies focused on the post-operation complications and long term outcomes of octogenarian patients with colorectal cancer. This meta-analysis based on published studies aims to assess the safety of treating octogenarian CRC patients with surgery. Methods Databases, including PubMed, Embase, and Cochrane Library were searched until July 2022. The incidence of preoperative comorbidities, postoperative complications, and mortality was assessed using odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Furthermore, the hazard ratios (HRs) with 95% CIs were applied for survival outcomes. Results A total of 13,790 patients with CRC in 21 studies were included. Our results demonstrated that octogenarian patients were associated with a higher burden of comorbidities (OR = 3.03;95% CI: 2.03, 4.53༛P = .000), high incidences of overall postoperative complications (OR = 1.63༛95% CI༚1.29,2.06༛P = .000), high internal medicine postoperative complications (OR = 2.38༛95% CI༚1.76, 3.21༛P = .000), high in-hospital mortality (OR = 4.01༛95% CI༚3.06, 5.27༛P = .000) and poor overall survival (OR = 2.13༛95% CI༚1.78, 2.55༛P = .000).But there is no statistical difference in surgery-related postoperative complications(OR = 1.16༛95% CI༚0.94, 1.43༛P = .16) and DFS༈OR = 1.03༛95% CI༚0.83, 1.29༛P = .775). Conclusions Considering the high burden of comorbidities, high incidences of postoperative complications and mortality, surgery for extremely elderly patients with CRC requires deliberation. Nevertheless, the survival outcomes of octogenarian and even older patients is similar to those of youth patients. Some of them might benefit from conservative treatments or palliative surgeries indeed. Hereby, individualized treatment is recommended for such patients. Instead of actual age, physical age is the real element the clinicians should take into consideration.

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“…On the authority of the NCCN guidelines 35 , colorectal cancer patients who are clinically diagnosed as T3…”

Section: Discussionmentioning

confidence: 99%

Is it safe to perform Enterectomy in colorectal cancer patients aged 80 or older? A meta-analysis and a systematic review

Chen

et al. 2023

Preprint

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“…Serum tumor markers play an important role in prognosis prediction for CRC patients due to their bene tcost ratio and convenience of measurement. CEA is recommended by main guidelines to be routinely measured in CRC [20,21]. Elevated preoperative serum CEA levels was associated with PALN metastasis and poor survival [6,16].…”

Section: Logistic Regression Analysis Of Risk Factors For Radiographi...mentioning

confidence: 99%

Risk Factor Analysis for Radiographic Para-aortic Lymph Nodes Metastasis in Left-sided Colorectal Cancer

Chen

Yang

Peng

et al. 2022

Preprint

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Purpose Synchronous para-aortic lymph node (PALN) metastasis from colorectal cancer (CRC) is rare, and the positive predictive value of pre-operative CT was low. This study aimed to clarify risk factors radiographic PALN metastasis in left‐sided CRC for improving the accuracy of pre-operative CT scan. Methods Patients with pathologically and radiographically confirmed diagnosis of left-sided CRC were enrolled between January 2019 and August 2021. The Correlations between clinicopathologic data and radiographic PALN metastasis were analyzed chi-squared test or Fisher exact test and the multivariate binary logistic regression model was used for multivariate analyses. Results There were 15(3.56%) patients with radiographic PALN metastasis. The hepatic (P=0.023) and inferior mesenteric lymph nodes (IMLN) (P<0.001) metastases, elevated serum carcinoembryonic antigen (CEA) (P=0.007) and carbohydrate antigen19-9 (CA19-9) (P=0.021) levels, longer tumor length (P=0.003), lower degree of tumor differentiation (P<0.001), deeper tumor invasion (P=0.038), later lymph node staging (P<0.001), perineural invasion (P=0.009) and lymphovascular involvement (P<0.001) were the risk factors for radiographic PALN metastasis. Among them, the radiographic IMLN metastasis (P=0.003, OR=20.927, 95% CI 2.823-155.820) was the only independent risk factor. Conclusion Some clinicopathologic characteristics, especially IMLN metastasis, are the risk factors for PALN metastasis.

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“…Cases of distant lung recurrence 20 years after curative surgery for rectal cancer, without local recurrence, are rare. This DFI is beyond the limits described in surveillance guidelines [ 3 ]. This report presents a rare case of such a presentation.…”

Section: Introductionmentioning

confidence: 95%

Distant Lung Recurrence of Rectal Cancer 20 Years After Primary Surgery

Gobishangar¹,

Gobinath²,

Thanenthiran³

et al. 2023

Cureus

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A male patient in his 70s, who had undergone an abdominoperineal (A1) resection for rectal cancer 20 years prior, presented with hemoptysis. Imaging studies revealed distant lung recurrence, with no evidence of local recurrence. Biopsy revealed an adenocarcinoma, possibly of rectal origin. Immunohistochemical markers were suggestive of rectal cancer metastasis. However, carcinoembryonic antigen (CEA) levels were normal, and colonoscopy did not reveal any metachronous lesions. Curative left upper lobe resection was performed via posterolateral thoracotomy. The patient's recovery was uneventful.

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Rectal Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology

Cited by 331 publications

References 251 publications

Is it safe to perform Enterectomy in colorectal cancer patients aged 80 or older? A meta-analysis and a systematic review

Is it safe to perform Enterectomy in colorectal cancer patients aged 80 or older? A meta-analysis and a systematic review

Risk Factor Analysis for Radiographic Para-aortic Lymph Nodes Metastasis in Left-sided Colorectal Cancer

Distant Lung Recurrence of Rectal Cancer 20 Years After Primary Surgery

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