Taiwan Society of Colon and Rectal Surgeons (TSCRS) Consensus for Cytoreduction Selection in Metastatic Colorectal Cance
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CONTINUING EDUCATION– PERITONEAL SURFACE MALIGNANCY
Taiwan Society of Colon and Rectal Surgeons (TSCRS) Consensus for Cytoreduction Selection in Metastatic Colorectal Cancer Chun-Chi Lin, MD1,2, Te-Hung Chen, MD3, Yu-Chung Wu, MD4, Chuan-Yin Fang, MD5, Jaw-Yuan Wang, MD, PhD6, Chou-Pin Chen, MD7, Kai-Wen Huang, MD, PhD8, and Jeng-Kai Jiang, MD, PhD1,2 1
Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; 2School of Medicine, National Yang-Ming University, Taipei, Taiwan; 3Department of Surgery, China Medical University Hospital, Taichung, Taiwan R.O.C.; 4Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; 5Division of Colorectal Surgery, Department of Surgery, Chia-Yi Christian Hospital, Chia-Yi City, Taiwan; 6Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; 7Division of Colorectal Surgery, Taichung Veterans General Hospital, Taichung, Taiwan; 8 Department of Surgery and Hepatitis Research Centre, Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
ABSTRACT Background. Taiwan has witnessed a surge in the incidence of colorectal cancer (CRC), of which 40–60% metastasize. Continuous updating of cytoreductive strategies in metastatic CRC (mCRC) has contributed to median overall survival reaching 40 months. In this changing scenario, to standardize the approaches across Taiwan, a group of experts from the Taiwan Society of Colon and Rectal Surgeons (TSCRS) convened to establish evidenceand opinion-based recommendations for defining the criteria of ‘‘resectability’’ in mCRC. Methods. Over the course of one-on-one consultations, lasting 30–40 min each, with 30 medical specialists (19 colorectal surgeons, 4 general surgeons, and 7 medical oncologists) from 16 hospitals in Taiwan followed by a 2-h meeting with 8 physician experts (3 general surgeons, 4 colorectal surgeons, and 1 thoracic surgeon), 12 key questions on cytoreduction were addressed. This was further contextualized based on published literature. Results. The final consensus includes eight recommendations regarding the criteria for metastasis resection, role of
Society of Surgical Oncology 2020 First Received: 5 March 2020 Accepted: 7 July 2020 J.-K. Jiang, MD, PhD e-mail: [email protected]
local control treatment in liver potentially resectable patients, management of synchronous liver metastases, approach for peritoneal metastasis, place for resection in multiple-organ metastasis, and general criteria for resectability. Conclusions. mCRC patients undergoing R0 resection have the greatest survival advantage following surgery. Our role as a multidisciplinary team (MDT) should be to treat potentially resectable mCRC patients as rapidly and safely as possible, and achieve R0 resection as far as possible and for as long as possible (continuum of care). This TSCRS consensus statement aims to help build clinical capacity within the MD
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