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 - Podda, Maria Vittoria
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 - Guerrieri, Maria Chiara
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 -