S3-Guidelines Colorectal Cancer 2004

Schmiegel, Wolff; Pox, Christian; Adler, Georg; Fleig, W E; Ur, Fölsch; Frühmorgen, P.; Graeven, U.; Hohenberger, Werner; Holstege, Axel; Junginger, T; Kühlbacher, T.; Porschen, R; Propping, Peter; Riemann, J F; Sauer, Rolf; Sauerbruch, Tilman; Schmoll, H.-J.; Zeitz, Martin; Selbmann, H K; Verdauungs, Deutschen Gesellschaft für

doi:10.1055/s-2004-813699

Cited by 112 publications

(21 citation statements)

References 276 publications

(388 reference statements)

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“…The use of oxaliplatin in the treatment of stage III and IV CRC has been recommended in the German guideline for colorectal cancer treatment since 2004 3 . The current guideline also recommends the use of adjuvant chemotherapy in high risk stage II patients.…”

Section: Introductionmentioning

confidence: 99%

Genetic variants in DNA repair genes as potential predictive markers for oxaliplatin chemotherapy in colorectal cancer

et al. 2015

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Oxaliplatin-based chemotherapy exerts its effects through generating DNA damage. Hence, genetic variants in DNA repair pathways could modulate treatment response. We used a prospective cohort of 623 CRC patients with stage II–IV disease treated with adjuvant/palliative chemotherapy to comprehensively investigate 1 727 genetic variants in the DNA repair pathways as potential predictive markers for oxaliplatin treatment. Single SNP associations with overall survival and recurrence free survival were assessed using a Cox regression model. Pathway analysis was performed using the gamma method. Patients carrying variant alleles of rs3783819 (MNAT1) and rs1043953 (XPC) experienced a longer overall survival after treatment with oxaliplatin than patients who did not carry the variant allele while the opposite association was found in patients who were not treated with oxaliplatin (FDR adjusted p-values for heterogeneity 0.0047 and 0.0237, respectively). The nucleotide excision repair (NER) pathway was found to be most likely associated with overall survival in patients who received oxaliplatin (p-value 0.002). Our data show that genetic variants in the NER pathway are potentially predictive of treatment response to oxaliplatin.

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Section: Introductionmentioning

confidence: 99%

Genetic variants in DNA repair genes as potential predictive markers for oxaliplatin chemotherapy in colorectal cancer

et al. 2015

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“…The German guidelines for the management of colorectal cancer were fundamentally changed in 2004 [2]. Neoadjuvant therapy was defined to be a new standard for lymph node-positive rectal cancers as well as for T3 rectal cancers.…”

Section: Discussionmentioning

confidence: 99%

“…The mortality rate is about 37/100,000 persons. The overall 5-year survival rate of rectal cancer is 45% (males) and 47% (females) [1,2]. …”

Section: Introductionmentioning

confidence: 99%

Incidence of Metachronous Distant Metastasis and ypN Classification Influence Patient Survival in Endosonographically Confirmed uT3 Rectal Cancer after Neoadjuvant Therapy and R0 Resection: A Historical Cohort Analysis

et al. 2016

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Background: Tumor response after neoadjuvant radiochemotherapy (NRC) prior to surgery and other parameters are likely to have an influence on the survival rate of patients suffering from T3 rectal cancer. Methods: 51 patients (17 female, 34 male; 59.0 years; Apache < 9 points: 95.1%; ASA I-II 88.3% and ASA III 11.8%) were treated with NRC (50.4 Gy; 5-fluorouracil/folinic acid) 4-6 weeks prior to surgery because of uT3 rectal cancer (G2: 96%; adenocarcinoma 86.3%; cUICC II 62.7%). NRC led to a tumor response (TR) (ypT0-ypT2) in 45.1% (ypT0N0M0 7.8%). Results: Neither the age of patients nor Apache/ASA score, histology, UICC staging, ypTNM, Dukes staging, infiltration of vessels, surgical procedure, local recurrence nor TR had a significant influence on the patients' survival time. Patients with metachronous distant metastasis (MDM) during the follow-up period (mean: 8.2 years; 1 month to 14.5 years) and patients with ypN1-ypN2 had a significantly shorter survival time. Conclusions: NRC prior to surgery leads to a remarkable TR rate but has no significant impact of TR on the patients' survival time. Occurrence of MDM during the follow-up period and ypN1/N2 status do have a greater influence. It is necessary to investigate larger cohorts of patients in the future to obtain more conclusive results and to define factors with influence on survival.

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“…Well-differentiated (G1/G2) small tumors (<3 cm) (ultrasound staging classification uT1, N0, and M0) can be cured with local excision. After surgical removal of pT1 low-risk tumors, no adjuvant chemotherapy is recommended [20]. In case of a higher postoperative T stage, an additional total mesorectal excision (TME) should be performed.…”

Section: Management Of Rectal Cancermentioning

confidence: 99%

Management of colorectal cancer

Stintzing

2014

F1000Prime Rep

106

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Colorectal cancer is one of the most frequent solid tumors in the Western world. Treatment options are dependent on the stage of the disease, the performance status of the patient, and increasingly the molecular makeup of the tumor. In countries with surveillance programs, the incidence rate as well as the mortality rate has gone down because of the earlier stages at which the tumors are detected. For rectal cancer, standard of care differs from that of colon cancer with regard to perioperative treatment. In the metastatic setting, treatment options are uniform for colorectal cancer. Over the years, treatment options have emerged from single-agent 5-fluorouracil (5-FU) treatment to combination regimens using 5-FU and oxaliplatin or irinotecan or both. Treatment efficacy in the metastatic setting has been increased with the introduction of targeted substances. These include (a) the anti-vascular endothelial growth factor-A (anti-VEGF-A) antibody bevacizumab, (b) the anti-epidermal growth factor receptor (anti-EGFR) antibodies cetuximab and panitumumab, (c) the anti-angiogenic multi-kinase inhibitor regorafenib, and (d) the anti-angiogenic compound aflibercept. Anti-EGFR antibodies have shown efficacy only in the subpopulations of tumors that do not have any mutation in KRAS and NRAS exon 2, 3, 4. Physicians have the choice in the first line to use anti-EGFR or anti-VEGF inhibitors in combination with chemotherapy based on treatment goals and patient performance. In recent years, tumor location has been shown to be prognostic and predictive for clinical outcome. Right-sided sporadic colon cancers differ significantly in molecular characteristics and, with the exception of microsatellite instability (MSI-H) tumors, are associated with poor prognosis. Tumors based on hereditary non-polyposis colorectal cancer, on the other hand, have excellent prognosis in stage II and III disease. Recent efforts have focused on the molecular classification of colorectal cancer with the purpose of establishing molecularly defined subgroups.

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S3-Guidelines Colorectal Cancer 2004

Cited by 112 publications

References 276 publications

Genetic variants in DNA repair genes as potential predictive markers for oxaliplatin chemotherapy in colorectal cancer

Genetic variants in DNA repair genes as potential predictive markers for oxaliplatin chemotherapy in colorectal cancer

Incidence of Metachronous Distant Metastasis and ypN Classification Influence Patient Survival in Endosonographically Confirmed uT3 Rectal Cancer after Neoadjuvant Therapy and R0 Resection: A Historical Cohort Analysis

Management of colorectal cancer

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