Guidelines 2000 for colon and rectal cancer surgery

被引:983
作者
Nelson, H
Petrelli, N
Carlin, A
Couture, J
Fleshman, J
Guillem, J
Miedema, B
Ota, D
Sargent, D
机构
[1] Mayo Clin & Mayo Fdn, Rochester, MN 55905 USA
[2] Roswell Pk Canc Inst, Buffalo, NY 14263 USA
[3] Wayne State Univ, Detroit, MI 48202 USA
[4] Mt Sinai Hosp, Toronto, ON M5G 1X5, Canada
[5] Barnes Jewish Hosp, St Louis, MO 63110 USA
[6] Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA
[7] Univ Missouri, Columbia, MO 65201 USA
[8] Ellis Fischel Canc Ctr, Columbia, MO USA
来源
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2001年 / 93卷 / 08期
关键词
D O I
10.1093/jnci/93.8.583
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Oncologic resection techniques affect outcome for colon cancer and rectal cancer, but standardized guidelines have not been adopted. The National Cancer Institute sponsored a panel of experts to systematically review current literature and to draft guidelines that provide uniform definitions, principles, and practices. Methods: Methods were similar to those described by the American Society of Clinical Oncology in developing practice guidelines. Experts representing oncology and surgery met to review current literature on oncologic resection techniques for level of evidence (I-V, where I is the best evidence and V is the least compelling) and grade of recommendation (A-D, where A is based on the best evidence and D is based on the weakest evidence). Initial guidelines were drafted, reviewed, and accepted by consensus, Results: For the following seven factors, the level of evidence was II, III, or IV, and the findings were generally consistent (grade B): anatomic definition of colon versus rectum, tumor-node-metastasis staging, radial margins, adjuvant RO stage, inadvertent rectal perforation, distal and proximal rectal margins, and en bloc resection of adherent tumors, For another seven factors, the level of evidence was II, III, or IV, but findings were inconsistent (grade C): laparoscopic colectomy; colon lymphadenectomy; level of proximal vessel ligation, mesorectal excision, and extended lateral pelvic lymph node dissection (all three for rectal cancer); no-touch technique; and bower washout. For the other four factors, there was little or no systematic empirical evidence (grade D): abdominal exploration, oophorectomy, extent of colon resection, and total length of rectum resected, Conclusions: The panel reports surgical guidelines and definitions based on the best available evidence. The availability of more standardized information in the future should allow for more grade A recommendations.
引用
收藏
页码:583 / 596
页数:14
相关论文
共 138 条
  • [81] SURGICAL PATHOLOGY OF RECTAL CANCER IN RELATION TO ADJUVANT RADIOTHERAPY
    MORSON, BC
    PATH, MC
    BUSSEY, HJR
    [J]. BRITISH JOURNAL OF RADIOLOGY, 1967, 40 (471) : 161 - &
  • [82] Nelson H, 1995, J Natl Cancer Inst Monogr, P51
  • [83] NG IOL, 1993, CANCER-AM CANCER SOC, V71, P1972, DOI 10.1002/1097-0142(19930315)71:6<1972::AID-CNCR2820710608>3.0.CO
  • [84] 2-V
  • [85] OLSON RM, 1980, CANCER-AM CANCER SOC, V45, P2969, DOI 10.1002/1097-0142(19800615)45:12<2969::AID-CNCR2820451214>3.0.CO
  • [86] 2-7
  • [87] EXTENDED RESECTION FOR LOCALLY ADVANCED PRIMARY ADENOCARCINOMA OF THE RECTUM
    ORKIN, BA
    DOZOIS, RR
    BEART, RW
    PATTERSON, DE
    GUNDERSON, LL
    ILSTRUP, DM
    [J]. DISEASES OF THE COLON & RECTUM, 1989, 32 (04) : 286 - 292
  • [88] LAPAROSCOPIC BOWEL SURGERY REGISTRY - PRELIMINARY-RESULTS
    ORTEGA, AE
    BEART, RW
    STEELE, GD
    WINCHESTER, DP
    GREENE, FL
    [J]. DISEASES OF THE COLON & RECTUM, 1995, 38 (07) : 681 - 685
  • [89] TREATMENT OF RECTAL-CANCER BY LOW ANTERIOR RESECTION WITH COLOANAL ANASTOMOSIS
    PATY, PB
    ENKER, WE
    COHEN, AM
    LAUWERS, GY
    [J]. ANNALS OF SURGERY, 1994, 219 (04) : 365 - 373
  • [90] LOCAL RECURRENCE FOLLOWING CURATIVE SURGERY FOR LARGE BOWEL-CANCER .1. THE OVERALL PICTURE
    PHILLIPS, RKS
    HITTINGER, R
    BLESOVSKY, L
    FRY, JS
    FIELDING, LP
    [J]. BRITISH JOURNAL OF SURGERY, 1984, 71 (01) : 12 - 16