SEOM clinical guidelines for diagnosis and treatment of metastatic colorectal cancer (2018)

Gomez-España, Maria Auxilidora; Gállego, Javier; González-Flores, E.; Maurel, Joan; Páez, David; Sastre, Javier; Aparicio, Jorge; Benavides, Manuel; Feliú, Jaime; Vera, Ruth

doi:10.1007/s12094-018-02002-w

Cited by 49 publications

(37 citation statements)

References 45 publications

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“…Although global mortality is decreasing, the subgroup of younger patients (<50 years old) has experienced a growing incidence and mortality rate. Up to one quarter of patients have metastatic colorectal cancer (mCRC) disease at initial diagnosis, and nearly half of those who are candidates for primary tumor surgery will eventually develop metastasis, resulting in a 5-year survival rate of 14% [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

BRAF Mutated Colorectal Cancer: New Treatment Approaches

Molina‐Cerrillo

Román

Pozas

et al. 2020

Cancers

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Colon cancer is one of the most frequently diagnosed malignancies in adults, considering both its incidence and prevalence. Anatomically, the right colon is considered as being from the cecum to the splenic flexure, and the left colon is from the splenic flexure to the rectum. Sidedness is a surrogate of a wide spectrum of colorectal cancer (CRC) biology features (embryology, microbiome, methylation, microsatellite instability (MSI), BRAF, aging, KRAS, consensus molecular subtypes (CMS), etc.), which result in prognostic factors. Different molecular subtypes have been identified, according to genomic and transcriptomic criteria. A subgroup harboring a BRAF mutation has been described, and represents approximately 10% of the patients diagnosed with colon cancer. This subgroup has morphological, clinical, and therapeutic characteristics that differ substantially from patients who do not carry this genetic alteration. Unfortunately, there is no established standard of care for this particular cohort of patients. This manuscript aims to study the biology of this subgroup of colon cancer, to understand the current approach in clinical research.

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Section: Introductionmentioning

confidence: 99%

BRAF Mutated Colorectal Cancer: New Treatment Approaches

Molina‐Cerrillo

Román

Pozas

et al. 2020

Cancers

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“…Conversely, 93% of experts did not consider triplet CT + anti-EGFR therapy to be the preferred option for BRAF mt patients, which aligns with the clinical guidelines [8,14]. There is currently no published data from Phase III RCTs that assess CT triplets with anti-EGFR therapy.…”

Section: Triplets (Table 3)mentioning

confidence: 93%

“…However, the differences described between the right and left colon may determine treatment approaches [9,[11][12][13]. The treatment goal was also considered relevant, but the molecular profile was deemed the most crucial factor for treatment selection, as expounded by the guidelines [14].…”

Section: Delphi Processmentioning

confidence: 99%

Controversies in the treatment of RAS wild-type metastatic colorectal cancer

et al. 2020

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Objective To provide guidance for the management of RAS wild-type (wt) metastatic colorectal cancer (mCRC) in daily practice. Methods Nominal group and Delphi techniques were used. A steering committee of seven experts analyzed the current management of RAS wt mCRC, through which they identified controversies, critically analyzed the available evidence, and formulated several guiding statements for clinicians. Subsequently, a group of 30 experts (the expert panel) was selected to test agreement with the statements, through two Delphi rounds. The following response categories were established in both rounds: 1 = totally agree, 2 = basically agree, 3 = basically disagree, 4 = totally disagree. Agreement was defined if ≥ 75% of answers were in categories 1 and 2 (consensus with the agreement) or 3 and 4 (consensus with the disagreement). Results Overall, 71 statements were proposed, which incorporated the following areas: (1) overarching principles; (2) tumor location; (3) triplets; (4) maintenance; (5) second-line and beyond treatments; (6) Rechallenge and liquid biopsy. After the two Delphi rounds, only six statements maintained a lack of clear consensus. Conclusions This document aims to describe the expert’s attitude when dealing with several common clinical questions regarding patients with RAS wt mCRC.

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“…[3][4][5] Currently, the major therapeutic method for colorectal cancer remains surgery. 6 Although postoperative pain management is the key component of perioperative care, most patients who undergo colonic surgery still have severe postoperative pain. 7,8 For elderly patients, early postoperative cognitive dysfunction (POCD) also affects the postoperative recovery.…”

Section: Introductionmentioning

confidence: 99%

Protective effect of dexmedetomidine infusion combined with epidural blockade on postoperative complications after surgery: A prospective randomized controlled clinical trial

Zhu

et al. 2020

J Int Med Res

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Objectives This prospective, randomized, controlled study aimed to explore the efficacy of dexmedetomidine combined with epidural blockade on postoperative recovery of elderly patients after radical resection for colorectal cancer. Methods Ninety-six elderly patients who underwent radical resection for colorectal cancer were randomly divided into the following four groups: dexmedetomidine, epidural blockade (ropivacaine), combined (dexmedetomidine + epidural blockade), and control (0.9% saline). The Mini-Mental State Examination (MMSE), Visual Analog Scale (VAS), and Ramsay scores at 48 hours, and time to first activity, length of hospital stay, and postoperative complication rates at 3 months were assessed. Results Twelve hours after surgery, Ramsay scores were higher in the combined compared with the control and epidural blockade groups. Twenty-four hours after surgery, MMSE scores were higher in the combined compared with the other groups. The combined group showed the lowest VAS scores except at 48 hours. Time to first activity and length of hospital stay were significantly shorter in the combined compared with the other groups. There was no difference in total postoperative complication rates among the groups. Conclusions A combination of intraoperative dexmedetomidine infusion and epidural blockade could mitigate pain after surgery, improve cognitive dysfunction in early surgery, and facilitate recovery.

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SEOM clinical guidelines for diagnosis and treatment of metastatic colorectal cancer (2018)

Cited by 49 publications

References 45 publications

BRAF Mutated Colorectal Cancer: New Treatment Approaches

BRAF Mutated Colorectal Cancer: New Treatment Approaches

Controversies in the treatment of RAS wild-type metastatic colorectal cancer

Protective effect of dexmedetomidine infusion combined with epidural blockade on postoperative complications after surgery: A prospective randomized controlled clinical trial

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