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

Mauro Podda; Patricia Sylla; Gianluca Baiocchi; Michel Adamina; Vanni Agnoletti; Ferdinando Agresta; Luca Ansaloni; Alberto Arezzo; Nicola Avenia; Walter Biffl; Antonio Biondi; Alberto Biondi; Simona Bui; Fabio C. Campanile; Paolo Carcoforo; Claudia Commisso; Antonio Crucitti; Nicola De’Angelis; Gian Luigi De’Angelis; Massimo De Filippo; Belinda De Simone; Salomone Di Saverio; Giorgio Ercolani; Gustavo P. Fraga; Francesco Gabrielli; Francesca Augusta Gabrielli; Federica Gaiani; Mario Guerrieri; Angelo Guttadauro; Yoram Kluger; Ari K. Leppaniemi; Andrea Loffredo; Tiziana Meschi; Ernest E. Moore; Monica Ortenzi; Francesco Pata; Dario Parini; Adolfo Pisanu; Gilberto Poggioli; Andrea Polistena; Alessandro Puzziello; Fabio Rondelli; Massimo Sartelli; Neil Smart; Michael E. Sugrue; Patricia Tejedor; Marco Vacante; Federico Coccolini; Justin Davies; Fausto Catena

doi:10.1186/s13017-021-00378-9

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

Mauro Podda
, Patricia Sylla
, Gianluca Baiocchi
, Michel Adamina
, Vanni Agnoletti
, Ferdinando Agresta
, Luca Ansaloni
, Alberto Arezzo
, Nicola Avenia
, Walter Biffl
, Antonio Biondi
, Alberto Biondi
, Simona Bui
, Fabio C. Campanile
, Paolo Carcoforo
, Claudia Commisso
, Antonio Crucitti
, Nicola De’Angelis
, Gian Luigi De’Angelis
, Massimo De Filippo

Belinda De Simone, Salomone Di Saverio, Giorgio Ercolani, Gustavo P. Fraga, Francesco Gabrielli, Francesca Augusta Gabrielli, Federica Gaiani, Mario Guerrieri, Angelo Guttadauro, Yoram Kluger, Ari K. Leppaniemi, Andrea Loffredo, Tiziana Meschi, Ernest E. Moore, Monica Ortenzi, Francesco Pata, Dario Parini, Adolfo Pisanu, Gilberto Poggioli, Andrea Polistena, Alessandro Puzziello, Fabio Rondelli, Massimo Sartelli, Neil Smart, Michael E. Sugrue, Patricia Tejedor, Marco Vacante, Federico Coccolini, Justin Davies, Fausto Catena

University Hospital of Cagliari
Icahn School of Medicine at Mount Sinai
University of Brescia
University of Basel
Ospedale M. Bufalini
AULSS2 Trevigiana del Veneto
University of Pavia
University of Turin
University of Perugia
Scripps Memorial Hospital
University of Catania
Azienda Ospedaliero - Universitaria di Parma
ASL VT - Ospedale “San Giovanni Decollato - Andosilla”
Sant'Anna University Hospital of Ferrara
Ospedale General Regionale F. Miulli
University of Parma
Poissy and Saint Germain en Laye Hospitals
University of Insubria
Morgagni-Pierantoni Hospital
Universidade Estadual de Campinas
University of Milan - Bicocca
Marche Polytechnic University
Rambam Health Care Campus Israel
University Hospital of Helsinki
Denver Health
Nicola Giannettasio Hospital
Cardiovascular Diagnosis and Endoluminal Interventions Santa Maria Della Misericordia Hospital
Alma Mater Studiorum University of Bologna
University of Rome La Sapienza
University of Salerno
Macerata Hospital
Exeter Hospital
Letterkenny University Hospital and CPM sEUBP Interreg Project
Hospital General Universitario Gregorio Marañon
University of Pisa
Cambridge University Hospitals NHS Foundation Trust
Maggiore Parma Hospital

Research output: Contribution to journal › Article

Abstract

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.

Original language	English
Pages (from-to)	1-38
Number of pages	38
Journal	World Journal of Emergency Surgery
Volume	16
DOIs	https://doi.org/10.1186/s13017-021-00378-9
Publication status	Published - 2021

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Consensus
Elderly
Frailty
Multidisciplinary management
Rectal cancer

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Podda, M., Sylla, P., Baiocchi, G., Adamina, M., Agnoletti, V., Agresta, F., Ansaloni, L., Arezzo, A., Avenia, N., Biffl, W., Biondi, A., Biondi, A., Bui, S., Campanile, F. C., Carcoforo, P., Commisso, C., Crucitti, A., De’Angelis, N., De’Angelis, G. L., ... Catena, F. (2021). 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. World Journal of Emergency Surgery, 16, 1-38. https://doi.org/10.1186/s13017-021-00378-9

Podda, Mauro ; Sylla, Patricia ; Baiocchi, Gianluca et al. / 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. In: World Journal of Emergency Surgery. 2021 ; Vol. 16. pp. 1-38.

@article{970076b178fc4eb2bbe8d00e7d637883,

title = "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",

abstract = "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{\textquoteright} 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{\textquoteright} 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{\textendash}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.",

keywords = "Consensus, Elderly, Frailty, Multidisciplinary management, Rectal cancer, Consensus, Elderly, Frailty, Multidisciplinary management, Rectal cancer",

author = "Mauro Podda and Patricia Sylla and Gianluca Baiocchi and Michel Adamina and Vanni Agnoletti and Ferdinando Agresta and Luca Ansaloni and Alberto Arezzo and Nicola Avenia and Walter Biffl and Antonio Biondi and Alberto Biondi and Simona Bui and Campanile, \{Fabio C.\} and Paolo Carcoforo and Claudia Commisso and Antonio Crucitti and Nicola De{\textquoteright}Angelis and De{\textquoteright}Angelis, \{Gian Luigi\} and \{De Filippo\}, Massimo and \{De Simone\}, Belinda and \{Di Saverio\}, Salomone and Giorgio Ercolani and Fraga, \{Gustavo P.\} and Francesco Gabrielli and Gabrielli, \{Francesca Augusta\} and Federica Gaiani and Mario Guerrieri and Angelo Guttadauro and Yoram Kluger and Leppaniemi, \{Ari K.\} and Andrea Loffredo and Tiziana Meschi and Moore, \{Ernest E.\} and Monica Ortenzi and Francesco Pata and Dario Parini and Adolfo Pisanu and Gilberto Poggioli and Andrea Polistena and Alessandro Puzziello and Fabio Rondelli and Massimo Sartelli and Neil Smart and Sugrue, \{Michael E.\} and Patricia Tejedor and Marco Vacante and Federico Coccolini and Justin Davies and Fausto Catena",

year = "2021",

doi = "10.1186/s13017-021-00378-9",

language = "English",

volume = "16",

pages = "1--38",

journal = "World Journal of Emergency Surgery",

issn = "1749-7922",

publisher = "BioMed Central",

}

Podda, M, Sylla, P, Baiocchi, G, Adamina, M, Agnoletti, V, Agresta, F, Ansaloni, L, Arezzo, A, Avenia, N, Biffl, W, Biondi, A, Biondi, A, Bui, S, Campanile, FC, Carcoforo, P, Commisso, C, Crucitti, A, De’Angelis, N, De’Angelis, GL, De Filippo, M, De Simone, B, Di Saverio, S, Ercolani, G, Fraga, GP, Gabrielli, F, Gabrielli, FA, Gaiani, F, Guerrieri, M, Guttadauro, A, Kluger, Y, Leppaniemi, AK, Loffredo, A, Meschi, T, Moore, EE, Ortenzi, M, Pata, F, Parini, D, Pisanu, A, Poggioli, G, Polistena, A, Puzziello, A, Rondelli, F, Sartelli, M, Smart, N, Sugrue, ME, Tejedor, P, Vacante, M, Coccolini, F, Davies, J & Catena, F 2021, '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', World Journal of Emergency Surgery, vol. 16, pp. 1-38. https://doi.org/10.1186/s13017-021-00378-9

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. / Podda, Mauro; Sylla, Patricia; Baiocchi, Gianluca et al.
In: World Journal of Emergency Surgery, Vol. 16, 2021, p. 1-38.

Research output: Contribution to journal › Article

TY - JOUR

T1 - 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

AU - Podda, Mauro

AU - Sylla, Patricia

AU - Baiocchi, Gianluca

AU - Adamina, Michel

AU - Agnoletti, Vanni

AU - Agresta, Ferdinando

AU - Ansaloni, Luca

AU - Arezzo, Alberto

AU - Avenia, Nicola

AU - Biffl, Walter

AU - Biondi, Antonio

AU - Biondi, Alberto

AU - Bui, Simona

AU - Campanile, Fabio C.

AU - Carcoforo, Paolo

AU - Commisso, Claudia

AU - Crucitti, Antonio

AU - De’Angelis, Nicola

AU - De’Angelis, Gian Luigi

AU - De Filippo, Massimo

AU - De Simone, Belinda

AU - Di Saverio, Salomone

AU - Ercolani, Giorgio

AU - Fraga, Gustavo P.

AU - Gabrielli, Francesco

AU - Gabrielli, Francesca Augusta

AU - Gaiani, Federica

AU - Guerrieri, Mario

AU - Guttadauro, Angelo

AU - Kluger, Yoram

AU - Leppaniemi, Ari K.

AU - Loffredo, Andrea

AU - Meschi, Tiziana

AU - Moore, Ernest E.

AU - Ortenzi, Monica

AU - Pata, Francesco

AU - Parini, Dario

AU - Pisanu, Adolfo

AU - Poggioli, Gilberto

AU - Polistena, Andrea

AU - Puzziello, Alessandro

AU - Rondelli, Fabio

AU - Sartelli, Massimo

AU - Smart, Neil

AU - Sugrue, Michael E.

AU - Tejedor, Patricia

AU - Vacante, Marco

AU - Coccolini, Federico

AU - Davies, Justin

AU - Catena, Fausto

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

KW - Consensus

KW - Elderly

KW - Frailty

KW - Multidisciplinary management

KW - Rectal cancer

KW - Consensus

KW - Elderly

KW - Frailty

KW - Multidisciplinary management

KW - Rectal cancer

UR - http://hdl.handle.net/10807/263094

U2 - 10.1186/s13017-021-00378-9

DO - 10.1186/s13017-021-00378-9

M3 - Article

SN - 1749-7922

VL - 16

SP - 1

EP - 38

JO - World Journal of Emergency Surgery

JF - World Journal of Emergency Surgery

ER -