Multidisciplinary management of elderly patients with rectal cancer: recommendations from the SICG (Italian Society of Geriatric Surgery), SIFIPAC (Italian Society of Surgical Pathophysiology), SICE (Italian Society of Endoscopic Surgery and new technologies), and the WSES (World Society of Emergency Surgery) International Consensus Project

被引：35

作者：

Podda, Mauro ^{[1
]}

Sylla, Patricia ^{[2
]}

Baiocchi, Gianluca ^{[3
]}

Adamina, Michel ^{[4
]}

Agnoletti, Vanni ^{[5
]}

Agresta, Ferdinando ^{[6
]}

Ansaloni, Luca ^{[7
]}

Arezzo, Alberto ^{[8
]}

Avenia, Nicola ^{[9
]}

Biffl, Walter ^{[10
]}

Biondi, Antonio ^{[11
]}

Bui, Simona ^{[12
]}

Campanile, Fabio C. ^{[13
]}

Carcoforo, Paolo ^{[14
]}

Commisso, Claudia ^{[15
]}

Crucitti, Antonio ^{[16
,17
]}

De'Angelis, Nicola ^{[18
]}

De'Angelis, Gian Luigi ^{[19
]}

De Filippo, Massimo ^{[15
]}

De Simone, Belinda ^{[20
]}

Di Saverio, Salomone ^{[21
]}

Ercolani, Giorgio ^{[22
]}

Fraga, Gustavo P. ^{[23
]}

Gabrielli, Francesco ^{[24
]}

Gaiani, Federica ^{[19
]}

Guerrieri, Mario ^{[25
]}

Guttadauro, Angelo ^{[24
]}

Kluger, Yoram ^{[26
]}

Leppaniemi, Ari K. ^{[27
]}

Loffredo, Andrea ^{[28
]}

Meschi, Tiziana ^{[29
]}

Moore, Ernest E. ^{[30
]}

Ortenzi, Monica ^{[25
]}

Pata, Francesco ^{[31
]}

Parini, Dario ^{[32
]}

Pisanu, Adolfo ^{[1
]}

Poggioli, Gilberto ^{[33
]}

Polistena, Andrea ^{[34
]}

Puzziello, Alessandro ^{[28
]}

Rondelli, Fabio ^{[9
]}

Sartelli, Massimo ^{[35
]}

Smart, Neil ^{[36
]}

Sugrue, Michael E. ^{[37
,38
]}

Tejedor, Patricia ^{[39
]}

Vacante, Marco ^{[11
]}

Coccolini, Federico ^{[40
]}

Davies, Justin ^{[41
]}

Catena, Fausto ^{[42
]}

机构：

[1] Azienda Osped Univ Cagliari, Cagliari Univ Hosp Casula, Dept Emergency Surg, Cagliari, Italy

[2] Mt Sinai Hosp, Div Colon & Rectal Surg, New York, NY 10029 USA

[3] Univ Brescia, Dept Clin & Expt Sci, ASST Cremona, Brescia, Italy

[4] Winterthur Univ Basel, Cantonal Hosp Winterthur, Dept Colorectal Surg, Basel, Switzerland

[5] Bufalini Hosp, ICU Dept, Cesena, Italy

[6] Vittorio Veneto Hosp, Dept Gen Surg, AULSS2 Trevigiana Veneto, Vittorio Veneto, Italy

[7] Univ Pavia, Gen Surg Unit 1, Pavia, Italy

[8] Univ Torino, Dept Surg Sci, Turin, Italy

[9] Univ Perugia, SC Chirurg Gen & Specialita Chirurg, Azienda Osped Santa Maria, Terni, Italy

[10] Scripps Mem Hosp, Trauma & Acute Care Surg, La Jolla, CA USA

[11] Univ Catania, Dept Gen Surg & Med Surg Specialties, Catania, Italy

[12] Azienda Osped Univ Parma, Dept Med Oncol, Parma, Italy

[13] ASL VT Osped San Giovanni Decollato Andosilla, Dept Surg, Civita Castellana, Italy

[14] Univ Ferrara, Univ Hosp Ferrara, Unit Gen Surg, Dept Surg, Ferrara, Italy

[15] Univ Hosp Parma, Dept Radiol, Parma, Italy

[16] Cristo Re Hosp, Gen & Minimally Invas Surg Unit, Rome, Italy

[17] Catholic Univ, Rome, Italy

[18] Reg Gen Hosp F Miulli, Unit Minimally Invas & Robot Digest Surg, Bari, Italy

[19] Univ Parma, Gastroenterol & Endoscopy Unit, Dept Med & Surg, Parma, Italy

[20] Poissy & St Germain Laye Hosp, Dept Gen & Metab Surg, Poissy, France

[21] Univ Insubria, Dept Surg, Varese, Italy

[22] Morgagni Pierantoni Hosp, Gen & Oncol Surg, AUSL Romagna, Forli, Italy

[23] Univ Estadual Campinas, Sch Med Sci, Div Trauma Surg, Campinas, SP, Brazil

[24] Univ Milano Bicocca, Milan, Italy

[25] Univ Politecn Marche, Ancona, Italy

[26] Rambam Hlth Care Campus, Div Gen Surg, Haifa, Israel

[27] Univ Helsinki, Helsinki Univ Hosp, Helsinki, Finland

[28] Univ Salerno, UOC Chirurg Gen, AOU San Giovanni Dio & Ruggi Aragona, Salerno, Italy

[29] Univ Parma, Parma Univ Hosp, Dept Med & Surg, Geriatr Rehabil Dept, Parma, Italy

[30] Denver Hlth, Ernest E Moore Shock Trauma Ctr, Denver, CO USA

[31] Osped Nicola Giannettasio, Corigliano Rossano, Italy

[32] Santa Maria Misericordia Hosp, Rovigo, Italy

[33] Alma Mater Studiorum Univ Bologna, St Orsola Hosp, Dept Med & Surg Sci, Surg Alimentary Tract, Bologna, Italy

[34] Sapienza Univ Roma, Dipartimento Chirurg Pietro Valdoni, Policlin Umberto 1, Rome, Italy

[35] Macerata Hosp, Dept Surg, Macerata, Italy

[36] Exeter Hosp, Exeter, Devon, England

[37] Letterkenny Univ Hosp, Letterkenny, Ireland

[38] CPM sEUBP Interreg Project, Letterkenny, Ireland

[39] Univ Hosp Gregorio Maranon, Madrid, Spain

[40] Pisa Univ Hosp, Gen Emergency & Trauma Surg Dept, Pisa, Italy

[41] Addenbrookes Hosp, Cambridge Colorectal Unit, Cambridge, England

[42] Parma Maggiore Hosp, Dept Emergency Surg, Parma, Italy

来源：

WORLD JOURNAL OF EMERGENCY SURGERY | 2021年 / 16卷 / 01期

关键词：

Rectal cancer; Elderly; Frailty; Multidisciplinary management; Consensus; QUALITY-OF-LIFE; SHORT-COURSE RADIOTHERAPY; TOTAL MESORECTAL EXCISION; PREOPERATIVE SHORT-COURSE; CLINICAL COMPLETE RESPONDERS; MINIMALLY INVASIVE SURGERY; LONG-COURSE CHEMORADIATION; ENDOLUMINAL LOCOREGIONAL RESECTION; LAPAROSCOPIC-ASSISTED RESECTION; OBSTRUCTIVE COLORECTAL-CANCER;

D O I：

10.1186/s13017-021-00378-9

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background and aims Although rectal cancer is predominantly a disease of older patients, current guidelines do not incorporate optimal treatment recommendations for the elderly and address only partially the associated specific challenges encountered in this population. This results in a wide variation and disparity in delivering a standard of care to this subset of patients. As the burden of rectal cancer in the elderly population continues to increase, it is crucial to assess whether current recommendations on treatment strategies for the general population can be adopted for the older adults, with the same beneficial oncological and functional outcomes. This multidisciplinary experts' consensus aims to refine current rectal cancer-specific guidelines for the elderly population in order to help to maximize rectal cancer therapeutic strategies while minimizing adverse impacts on functional outcomes and quality of life for these patients. Methods The discussion among the steering group of clinical experts and methodologists from the societies' expert panel involved clinicians practicing in general surgery, colorectal surgery, surgical oncology, geriatric oncology, geriatrics, gastroenterologists, radiologists, oncologists, radiation oncologists, and endoscopists. Research topics and questions were formulated, revised, and unanimously approved by all experts in two subsequent modified Delphi rounds in December 2020-January 2021. The steering committee was divided into nine teams following the main research field of members. Each conducted their literature search and drafted statements and recommendations on their research question. Literature search has been updated up to 2020 and statements and recommendations have been developed according to the GRADE methodology. A modified Delphi methodology was implemented to reach agreement among the experts on all statements and recommendations. Conclusions The 2021 SICG-SIFIPAC-SICE-WSES consensus for the multidisciplinary management of elderly patients with rectal cancer aims to provide updated evidence-based statements and recommendations on each of the following topics: epidemiology, pre-intervention strategies, diagnosis and staging, neoadjuvant chemoradiation, surgery, watch and wait strategy, adjuvant chemotherapy, synchronous liver metastases, and emergency presentation of rectal cancer.

引用

页数：38

共 275 条

[51] Quality of life in patients with loco-regional rectal cancer after ELRR by TEM versus VLS TME after nChRT: long-term results [J].

D'Ambrosio, Giancarlo ;

Picchetto, Andrea ;

Campo, Salvatore ;

Palma, Rossella ;

Panetta, Cristina ;

De Laurentis, Francesca ;

La Rocca, Stefania ;

Lezoche, Emanuele .

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2019, 33 (03) :941-948

[52] Quality of life in non-early rectal cancer treated by neoadjuvant radio-chemotherapy and endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) versus laparoscopic total mesorectal excision [J].

D'Ambrosio, Giancarlo ;

Paganini, Alessandro M. ;

Balla, Andrea ;

Quaresima, Silvia ;

Ursi, Pietro ;

Bruzzone, Paolo ;

Picchetto, Andrea ;

Mattei, Fabrizio I. ;

Lezoche, Emanuele .

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2016, 30 (02) :504-511

[53]

D'Ambrosio G, 2015, ANN ITAL CHIR, V86, P56

[54] Impact of enhanced recovery after surgery protocols on postoperative morbidity and mortality in patients undergoing routine hepatectomy: review of the current evidence [J].

Damania, Rahul ;

Cocieru, Andrei .

ANNALS OF TRANSLATIONAL MEDICINE, 2017, 5 (17)

[55] Early Closure of a Temporary Ileostomy in Patients With Rectal Cancer A Multicenter Randomized Controlled Trial [J].

Danielsen, Anne K. ;

Park, Jennifer ;

Jansen, Jens E. ;

Bock, David ;

Skullman, Stefan ;

Wedin, Anette ;

Marinez, Adiela Correa ;

Haglind, Eva ;

Angenete, Eva ;

Rosenberg, Jacob .

ANNALS OF SURGERY, 2017, 265 (02) :284-290

[56] Transanal endoscopic microsurgery versus total mesorectal excision of T1 rectal adenocarcinomas with curative intention [J].

De Graaf, E. J. R. ;

Doornebosch, P. G. ;

Tollenaar, R. A. E. M. ;

Kranenbarg, E. Meershoek-Klein ;

de Boer, A. C. ;

Bekkering, F. C. ;

van de Velde, C. J. H. .

EJSO, 2009, 35 (12) :1280-1285

[57] The accuracy of MRI, endorectal ultrasonography, and computed tomography in predicting the response of locally advanced rectal cancer after preoperative therapy: A metaanalysis [J].

de Jong, Ellen A. ;

ten Berge, Josianne C. E. M. ;

Dwarkasing, Roy S. ;

Rijkers, Anton P. ;

van Eijck, Casper H. J. .

SURGERY, 2016, 159 (03) :688-699

[58] Surgical and regional treatments for colorectal cancer metastases in older patients: A systematic review and meta-analysis [J].

de'Angelis, Nicola ;

Baldini, Capucine ;

Brustia, Raffaele ;

Pessaux, Patrick ;

Sommacale, Daniele ;

Laurent, Alexis ;

Le Roy, Bertrand ;

Tacher, Vania ;

Kobeiter, Hicham ;

Luciani, Alain ;

Paillaud, Elena ;

Aparicio, Thomas ;

Canui-Poitrine, Florence ;

Liuu, Evelyne .

PLOS ONE, 2020, 15 (04)

[59] Robotic Versus Laparoscopic Colorectal Cancer Surgery in Elderly Patients: A Propensity Score Match Analysis [J].

de'Angelis, Nicola ;

Abdalla, Solafah ;

Bianchi, Giorgio ;

Memeo, Riccardo ;

Charpy, Cecile ;

Petrucciani, Niccolo ;

Sobhani, Iradj ;

Brunetti, Francesco .

JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES, 2018, 28 (11) :1334-1345

[60] Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations [J].

Decoster, L. ;

Van Puyvelde, K. ;

Mohile, S. ;

Wedding, U. ;

Basso, U. ;

Colloca, G. ;

Rostoft, S. ;

Overcash, J. ;

Wildiers, H. ;

Steer, C. ;

Kimmick, G. ;

Kanesvaran, R. ;

Luciani, A. ;

Terret, C. ;

Hurria, A. ;

Kenis, C. ;

Audisio, R. ;

Extermann, M. .

ANNALS OF ONCOLOGY, 2015, 26 (02) :288-300

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