Sistema de Salut de Catalunya
Institut Català de la Salut
[Siriwardena AK] Hepato-Pancreato-Biliary Unit, Manchester Royal Infirmary, Manchester, UK. [Serrablo A] Department of Surgery, Miguel Servet University Hospital, Zaragoza, Spain. [Fretland ÅA] Department of Surgery, Oslo University Hospital, Oslo, Norway. [Wigmore SJ] Hepatobiliary and Liver Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, UK. [Ramia-Angel JM] Department of Surgery, University Hospital of Guadalajara, Guadalajara, Spain. [Malik HZ] Liver Surgery Unit, Royal Liverpool University Hospital, Liverpool, UK. [Pellino G] Unitat de Cirurgia de Còlon i Recte, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania ‘Luigi Vanvitelli’, Naples, Italy
Vall d'Hebron Barcelona Hospital Campus
2023-08-23T07:00:27Z
2023-08-23T07:00:27Z
2023-08-11
Consensus; Colorectal cancer; Liver metastases
Consens; Càncer colorectal; Metàstasis hepàtiques
Consenso; Cáncer colorrectal; Metástasis hepáticas
Background Contemporary management of patients with synchronous colorectal cancer and liver metastases is complex. The aim of this project was to provide a practical framework for care of patients with synchronous colorectal cancer and liver metastases, with a focus on terminology, diagnosis, and management. Methods This project was a multiorganizational, multidisciplinary consensus. The consensus group produced statements which focused on terminology, diagnosis, and management. Statements were refined during an online Delphi process, and those with 70 per cent agreement or above were reviewed at a final meeting. Iterations of the report were shared by electronic mail to arrive at a final agreed document comprising 12 key statements. Results Synchronous liver metastases are those detected at the time of presentation of the primary tumour. The term ‘early metachronous metastases' applies to those absent at presentation but detected within 12 months of diagnosis of the primary tumour, the term ‘late metachronous metastases’ applies to those detected after 12 months. ‘Disappearing metastases’ applies to lesions that are no longer detectable on MRI after systemic chemotherapy. Guidance was provided on the recommended composition of tumour boards, and clinical assessment in emergency and elective settings. The consensus focused on treatment pathways, including systemic chemotherapy, synchronous surgery, and the staged approach with either colorectal or liver-directed surgery as first step. Management of pulmonary metastases and the role of minimally invasive surgery was discussed. Conclusion The recommendations of this contemporary consensus provide information of practical value to clinicians managing patients with synchronous colorectal cancer and liver metastases.
Article
Published version
English
Decisió de grup; Còlon - Càncer - Diagnòstic; Recte - Càncer - Diagnòstic; DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms; Other subheadings::Other subheadings::/diagnosis; DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Liver Neoplasms; PSYCHIATRY AND PSYCHOLOGY::Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias gastrointestinales::neoplasias intestinales::neoplasias colorrectales; Otros calificadores::Otros calificadores::/diagnóstico; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias hepáticas; PSIQUIATRÍA Y PSICOLOGÍA::conducta y mecanismos de la conducta::psicología social::procesos de grupo::consenso
Oxford University Press
British Journal of Surgery;110(9)
https://doi.org/10.1093/bjs/znad124
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3439]
