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61. The Swedish rectal cancer registry

Author

Påhlman, L., Bohe, M., Cedermark, B., Dahlberg, M., Lindmark, G., Sjödahl, R., Öjerskog, B., Damber, L., and Johansson, R.

Published
2007

78. 90th Annual Convention Poster Presentations and Abstracts

Author

Ellis, C. N., Coyle, D. J., Boggs, H. W., Slagle, G. W., Cole, P. A., Kuramoto, S., Ihara, O., Oohara, T., Nichols, J., Opelka, F., Gathright, J. B., Green, J. B., Poulard, J. B., Ott, A., Bank, S., Margolis, I. B., Meagher, A., Stuart, M., Heine, J. A., Rothenberger, D. A., Nemer, F. D., Christenson, C. E., Saad, R. C., Church, J. M., Fazio, V. W., Lavery, I. C., Oakley, J. R., Milsom, J. W., Schroeder, T. K., Påhlman, L., Frykholm, G., Glimelius, B., Kashtan, H., Papa, M., Wilson, B., Stern, H., Zelnick, R., Haas, P., Ajlouni, M., Fox, T., Szilagy, E., Cummings, B. J., Fleshman, J. W., Dreznick, Z., Fry, R. D., Kodner, I. J., Perry, R. E., Pemberton, J. H., Litchy, W. L., Ferrara, A., Levin, K. E., Hanson, R. B., Cali, R. L., Blatchford, G. J., Thorson, A. G., Christenson, M. A., Pitsch, R. M., Jensen, L. L., Lowry, A. C., Keighley, M. R. B., Oya, M., Oritz, J., Pinho, M., Asperer, J., Chattaphaday, G., Baeten, C., Konsten, J., Spaans, F., Soeters, P., Habets, A., Schouten, W. R., Ruseler van Embden, J. G. H., Auwerda, J. J. A., Sagar, P. M., Goodwin, P., Holdsworth, P. J., Johnston, D., Bundy, C. A., Jacobs, D. M., Bubrick, M. P., Kashiwagi, H., Konishi, F., Kanazawa, K., Woodland, D. O., Saclarides, T. J., Bapna, M. S., Kubota, Y., Sunouchi, K., Ono, M., Muto, T., Masaki, T., Suzuki, K., Adachi, M., Wong, W. D., Goldberg, S. M., Wexner, S. D., Daniel, N., Jagelman, D. G., Christiansen, J., Rasmussen, O., Zhu, B. -W., Williams, J. G., Schottler, J. L., Heyman, S., Marchetti, F., Timmcke, A. E., Hicks, T. C., Ray, J. E., Bernstein, M. A., Madoff, R. D., Caushaj, P. F., Zarbo, R. J., Ma, C. K., Shida, H., Yamamoto, T., Machida, T., Imanari, T., Wang, J. Y., You, Y. T., Tang, R. P., Chen, J. S., Chang-Chien, C. R., Sugihara, K., Hojo, K., Moriya, Y., Hasegawa, H., Krueger, B., Warren, W., Faber, L. P., Abel, M. E., Chiu, Y. S. Y., Russell, T. R., Volpe, P. A., Frazee, R. C., Roberts, J., Symmonds, S., Snyder, S., Hendricks, J., Smith, R., Merchant, N., Hashmi, H., Scalea, T., Whelan, R., Longo, W. E., Gusberg, B. J., Ballantyne, G. H., Davidson, T., Allen-Mersh, T. G., Gazzard, B., Miles, A. J. G., Wastell, C., Viponde, M., Stotter, A., Miller, R. F., Fieldman, N., Slack, W. W., Tjandra, J., Savoca, P. E., Flannery, J. T., Modlin, I. M., Tsukada, K., Tazawa, K., Lavery, E. C., Voeller, G. R., Bunch, G., Britt, L. G., Neto, J. A. Reis, Quilici, F. A., Cordeiro, F., Reis, Jr, J. A., Wojcik, J. B., Banerjee, S. R., Walters, D. L., Cherry, D. A., Bleday, R., Pena, J. P., Buls, J. G., Pascual, R., Tripodi, G., Padmanabhan, A., Schouter, W. R., Blankensteijn, J. D., Moenning, S., Huber, P., Simonton, C., Odom, C., Kaplan, E., Nightengale, S., Shah, P. C., Hashami, H. F., Kottmeier, P., Velcek, F., Klotz, D., Whelan, R. L., Sher, M. E., Bauer, J. J., Gelernt, I., Launer, D. P., Gerber, A., Nogueras, J. J., Finne, C. O., Sohn, N., Weinstein, M. A., Lugo, R. N., Eisenberg, M. M., Tsao, J., Galandiuk, S., Tuckson, W. B., Strong, S., Oakey, J. R., Ambroze, W. L., Dozois, R. R., Carpenter, H. A., Kartheuser, A. H., LaRusso, N. F., Wiesner, R. H., Ilstrup, D. M., Schleck, C. D., Ambroze, W., Beart, R., Dozois, R., Wolff, B., Pemberton, J., Kelly, K., Devine, R., Nivatvongs, S., Metzger, P., Phillips, S. F., Zinmeister, A. R., Pezim, M. E., Vignati, P., Cohen, J., Stahl, T. J., Roberts, P. L., Schoetz, Jr., D. J., Murray, J. J., Coller, J. A., Veidenheimer, M. C., Yamazaki, Y., Ribeiro, M. B., Sachar, D., Heimann, T. M., Aufses, A. H., Greenstein, A. J., Stryker, S. J., Green, D., McLeod, R. S., Cohen, Z., Cullen, J., Greenberg, G. R., Ho, C. S., Reznick, R., Wolff, B. G., Cangemi, J., Carryer, P., Jeejeebhoy, K. N., MacCarty, R., Weilland, L., Senagore, A. J., MacKeigan, J. M., Guillem, J., Ondrula, D. P., Prasad, M. L., Nelson, R. L., Abcarian, H., Coughlin, R. J., Corman, M. L., Prager, E. D., Borison, D. I., Bloom, A. D., Pritchard, T. J., McGannon, E., Sivak, M. V., van Stolk, R., Hull-Boiner, S., Milson, J. W., Sullivan, M., Rosato, G. O., Jorge, J. M., Durdey, P., Kennedy, M. J., Oster, M., Murray, J., Cirocco, W. C., Rusin, L. C., Brown, A. C., Reilly, J. C., Cataldo, P., Luchtefeld, M. A., Mazier, W. P., Wolkomir, A. F., Ruiz-Moreno, F., Alvarado-Cerna, R., Rodriguez, U., Amaro, J., Kerner, B. A., Oliver, G. C., Eisenstat, T. E., Rubin, R. J., Salvati, E. P., Dominguez, J. M., Coon, J. S., Weinstein, R. S., Kameyama, M., Fukuda, I., Imaoka, S., Iwanga, T., Kyzer, S., Mitmaker, B., Gordon, P. H., Wang, E., Grace, R. H., Gibbons, P., Scott, K. M. W., Berger, A., Mischinger, H. J., Arian-Schad, K., Davis, M., Miller, D., Fielding, L. P., Begin, L. R., Bell, A. M., Shafik, A., Abdel-Moneim, K., Khalid, A., Devine, R. M., Beart, Jr., R. W., Melton, L. J., Ngoi, S. S., Chia, J., Goh, P., Sim, E., Godwin, P., Quirke, P., Barrett, R. C., Koltun, W. A., Smith, R. J., Loehner, D., Roberts, P., Veidenheimer, M., Schoetz, D., Chattopadhyay, G., Kumar, D., Hosie, K., Kmiot, W., Mostaf, A., Tulley, N., Harding, I., Falcone, R. E., Wanamaker, S., Santanello, S. A., Carey, L. C., Rivera, D. E., Durdley, P., Gross, P. T., Sarles, J. C., Arnaud, A., Sielezneff, I., Orsoni, P., Joly, A., Limberg, B., Stolfi, V. M., Lavery, I., Oakley, J., Church, J., Fazio, V., Asbun, H. J., Castellanos, H., Asbun, J., Franko, E. R., Ivatury, R. R., Schwalb, D., Saad, R., Schroeder, T., Reis, Jr., J. A., Dziki, A. J., Duncan, M. D., Harmon, J. W., Saini, N., Malthaner, R. A., Fernicola, M. T., Hakki, F. Z., Trad, K. S., Ugarte, R. M., Ryan, P., Chang, H. R., Chavoshan, B., Barsoum, G., Bonardi, R., Scaramelo, A., Possebon, A., Peres, C., Röhrig, C., Kappas, A. M., Ortiz, J., Fan, H. A., Milsom, J., Lechner, P., Lind, P., Cesnik, H., Venkatesh, K. S., Larson, D. M., Morrison, D. N., Ramanujam, P. J., Rubbini, M., Mascoli, F., Mari, C., Bresadola, V., and Donini, I.

Published
1991
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88. COMPRES: A prospective postmarketing evaluation of the compression anastomosis ring CAR 27™/ColonRing™

Author

D'Hoore, A, Albert, MR, Cohen, SM, Herbst, F, Matter, I, Van Der Speeten, K, Dominguez, J, Rutten, H, Muldoon, JP, Bardakcioglu, O, Senagore, AJ, Ruppert, R, Mills, S, Stamos, MJ, Påhlman, L, Choman, E, Wexner, SD, and On behalf of the COMPRES collaborative study group

Abstract

© 2015 The Association of Coloproctology of Great Britain and Ireland 17 6 June 2015 10.1111/codi.12884 Original Article Original Articles General Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland. Aim: Preclinical studies have suggested that nitinol-based compression anastomosis might be a viable solution to anastomotic leak following low anterior resection. A prospective multicentre open label study was therefore designed to evaluate the performance of the ColonRing™ in (low) colorectal anastomosis. Method: The primary outcome measure was anastomotic leakage. Patients were recruited at 13 different colorectal surgical units in Europe, the United States and Israel. Institutional review board approval was obtained. Results: Between 21 March 2010 and 3 August 2011, 266 patients completed the study protocol. The overall anastomotic leakage rate was 5.3% for all anastomoses, including a rate of 3.1% for low anastomoses. Septic anastomotic complications occurred in 8.3% of all anastomoses and 8.2% of low anastomoses. Conclusion: Nitinol compression anastomosis is safe, effective and easy to use and may offer an advantage for low colorectal anastomosis. A prospective randomized trial comparing ColonRing™ with conventional stapling is needed. Copyright

Published
2015
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89. Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer

Author

Deijen, C.L. (Charlotte L.), Vasmel, J.E. (Jeanine E.), De Lange-De Klerk, E.S.M. (E. S M), Cuesta, M.A. (Miguel), Coene, P-P. (Peter Paul), Lange, J.F. (Johan), Meijerink, W.J.H.J. (Jeroen), Jakimowicz, J.J. (Jack), Jeekel, J. (Hans), Kazemier, G. (Geert), Janssen, I.M.C. (Ignace M. C.), Påhlman, L. (Lars), Haglind, E. (Eva), Bonjer, H.J. (H. Jaap), Deijen, C.L. (Charlotte L.), Vasmel, J.E. (Jeanine E.), De Lange-De Klerk, E.S.M. (E. S M), Cuesta, M.A. (Miguel), Coene, P-P. (Peter Paul), Lange, J.F. (Johan), Meijerink, W.J.H.J. (Jeroen), Jakimowicz, J.J. (Jack), Jeekel, J. (Hans), Kazemier, G. (Geert), Janssen, I.M.C. (Ignace M. C.), Påhlman, L. (Lars), Haglind, E. (Eva), and Bonjer, H.J. (H. Jaap)

Abstract

Background: Laparoscopic surgery for colon cancer is associated with improved recovery and similar cancer outcomes at 3 and 5 years in comparison with open surgery. However, long-term survival rates have rarely been reported. Here, we present survival and recurrence rates of the Dutch patients included in the COlon cancer Laparoscopic or Open Resection (COLOR) trial at 10-year follow-up. Methods: Between March 1997 and March 2003, patients with non-metastatic colon cancer were recruited by 29 hospitals in eight countries and randomised to either laparoscopic or open surgery. Main inclusion criterion for the COLOR trial was solitary adenocarcinoma of the left or right colon. The primary outcome was disease-free survival at 3 years, and secondary outcomes included overall survival and recurrence. The 10-year follow-up data of all Dutch patients were collected. Analysis was by intention-to-treat. The trial was registered at ClinicalTrials.gov (NCT00387842). Results: In total, 1248 patients were randomised, of which 329 were Dutch. Fifty-eight Dutch patients were excluded and 15 were lost to follow-up, leaving 256 patients for 10-year analysis. Median follow-up was 112 months. Disease-free survival rates were 45.2 % in the laparoscopic group and 43.2 % in the open group (difference 2.0 %; 95 % confidence interval (CI) −10.3 to 14.3; p = 0.96). Overall survival rates were 48.4 and 46.7 %, respectively (difference 1.7 %; 95 % CI −10.6 to 14.0; p = 0.83). Stage-specific analysis revealed similar survival rates for both groups. Sixty-two patients were diagnosed with recurrent disease, accounting for 29.4 % in the laparoscopic group and 28.2 % in the open group (difference 1.2 %; 95 % CI −11.1 to 13.5; p = 0.73). Seven patients had port- or wound-site recurrences (laparoscopic n =

Published
2016
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90. International preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teams

Author

Augestad KM, Lindsetmo RO, Stulberg J, Reynolds H, Senagore A, Champagne B, Heriot AG, Leblanc F, Delaney CP, Ambrosetti P, Andujar J, Baixuli J, Balen E, Baxter N, Beck D, Bemelman W, Bergamaschi R, Billingham R, Birch D, Bonardi R, Bonardi M, Bonjer J, Braga M, Buch H, Buechler M, Burnstein M, Campbell K, Caushaj P, Celebrezze J, Chang G, Cheong D, Cohen J, Colak T, Delaney C, Dhoore A, Douglas P, Dozois E, Efron J, Ellis N, Enker W, Fanelli RD, Fazio V, Fleshman J, Franklin M, Fry R, Garcia Aguilar J, Garcia Granero E, Habr Gama A, Hahnloser D, Harris G, Hasegawa H, Holm T, Horgan P, Hyman N, Irwin T, Joh YG, Jongen J, Kaiser A, Kang SB, Kariv Y, Kennedy R, Kessler H, Khan M, Kim SH, Krokowicz P, Kwok S, Lacy A, Larson D, Law WL, Lee E, Lippert H, Ludwig K, Lynch AC, MacRae H, Madbouly K, Maeda K, Marderstein E, Marino M, Marks J, Maurer C, McLeod R, Monson J, Mortensen N, Neary P, Newstead G, OBrien D, Orangio G, Orkin B, Page M, Påhlman L, Panis Y, Panton N, Pennickx F, Phang T, Pinedo Mancilla G, Post S, Rafferty J, Rajput A, Reis Neto dos JA, Rivadeneira D, Roselli J, Rosen H, Rossi G, Rouanet P, Rullier E, Schiedeck T, Schiessel R, Schlachta C, Schwenk W, Seow Choen F, Sim R, Sing WK, Stamos M, Sternberg J, Tuckson W, Vaccaro C, Vargas D, Vignali A, Vonen B, Weiss E, Wexner S, Whiteford M, Wibe A, Williams N, Woods R, Yamamoto T, Young Fadok T., UGOLINI, GIAMPAOLO, Augestad KM, Lindsetmo RO, Stulberg J, Reynolds H, Senagore A, Champagne B, Heriot AG, Leblanc F, Delaney CP, Ambrosetti P, Andujar J, Baixuli J, Balen E, Baxter N, Beck D, Bemelman W, Bergamaschi R, Billingham R, Birch D, Bonardi R, Bonardi M, Bonjer J, Braga M, Buch H, Buechler M, Burnstein M, Campbell K, Caushaj P, Celebrezze J, Chang G, Cheong D, Cohen J, Colak T, Delaney C, Dhoore A, Douglas P, Dozois E, Efron J, Ellis N, Enker W, Fanelli RD, Fazio V, Fleshman J, Franklin M, Fry R, Garcia-Aguilar J, Garcia-Granero E, Habr-Gama A, Hahnloser D, Harris G, Hasegawa H, Holm T, Horgan P, Hyman N, Irwin T, Joh YG, Jongen J, Kaiser A, Kang SB, Kariv Y, Kennedy R, Kessler H, Khan M, Kim SH, Krokowicz P, Kwok S, Lacy A, Larson D, Law WL, Lee E, Lippert H, Ludwig K, Lynch AC, MacRae H, Madbouly K, Maeda K, Marderstein E, Marino M, Marks J, Maurer C, McLeod R, Monson J, Mortensen N, Neary P, Newstead G, OBrien D, Orangio G, Orkin B, Page M, Påhlman L, Panis Y, Panton N, Pennickx F, Phang T, Pinedo Mancilla G, Post S, Rafferty J, Rajput A, Reis Neto dos JA, Rivadeneira D, Roselli J, Rosen H, Rossi G, Rouanet P, Rullier E, Schiedeck T, Schiessel R, Schlachta C, Schwenk W, Seow-Choen F, Sim R, Sing WK, Stamos M, Sternberg J, Tuckson W, Ugolini G, Vaccaro C, Vargas D, Vignali A, Vonen B, Weiss E, Wexner S, Whiteford M, Wibe A, Williams N, Woods R, Yamamoto T, Young-Fadok T., Augestad, K, Lindsetmo, R, Stulberg, J, Reynolds, H, Senagore, A, Champagne, B, Heriot, A, Leblanc, F, Delaney, C, Ambrosetti, P, Andujar, J, Baixuli, J, Balen, E, Baxter, N, Beck, D, Bemelman, W, Bergamaschi, R, Billingham, R, Birch, D, Bonardi, R, Bonardi, M, Bonjer, J, Braga, M, Buch, H, Buechler, M, Burnstein, M, Campbell, K, Caushaj, P, Celebrezze, J, Chang, G, Cheong, D, Cohen, J, Colak, T, Dhoore, A, Douglas, P, Dozois, E, Efron, J, Ellis, N, Enker, W, Fanelli, R, Fazio, V, Fleshman, J, Franklin, M, Fry, R, Garcia-Aguilar, J, Garcia-Granero, E, Habr-Gama, A, Hahnloser, D, Harris, G, Hasegawa, H, Holm, T, Horgan, P, Hyman, N, Irwin, T, Joh, Y, Jongen, J, Kaiser, A, Kang, S, Kariv, Y, Kennedy, R, Kessler, H, Khan, M, Kim, S, Krokowicz, P, Kwok, S, Lacy, A, Larson, D, Law, W, Lee, E, Lippert, H, Ludwig, K, Lynch, A, Macrae, H, Madbouly, K, Maeda, K, Marderstein, E, Marino, M, Marks, J, Maurer, C, Mcleod, R, Monson, J, Mortensen, N, Neary, P, Newstead, G, Obrien, D, Orangio, G, Orkin, B, Page, M, Pahlman, L, Panis, Y, Panton, N, Pennickx, F, Phang, T, Pinedo Mancilla, G, Post, S, Rafferty, J, Rajput, A, Reis Neto dos, J, Rivadeneira, D, Roselli, J, Rosen, H, Rossi, G, Rouanet, P, Rullier, E, Schiedeck, T, Schiessel, R, Schlachta, C, Schwenk, W, Seow-Choen, F, Sim, R, Sing, W, Stamos, M, Sternberg, J, Tuckson, W, Ugolini, G, Vaccaro, C, Vargas, D, Vignali, A, Vonen, B, Weiss, E, Wexner, S, Whiteford, M, Wibe, A, Williams, N, Woods, R, Yamamoto, T, and Young-Fadok, T

Subjects
medicine.medical_specialty, Internationality, Colorectal cancer, health care facilities, manpower, and services, medicine.medical_treatment, education, Preoperative care, Article, RECTAL CANCER, COLORECTAL SURGERY, Preoperative Care, MANAGEMENT, Medicine, Humans, Stage (cooking), health care economics and organizations, Neoadjuvant therapy, Neoplasm Staging, Patient Care Team, Rectal Neoplasm, medicine.diagnostic_test, business.industry, Rectal Neoplasms, General surgery, Cancer, Rectal examination, Vascular surgery, medicine.disease, humanities, Neoadjuvant Therapy, Surgery, Treatment Outcome, Health Care Survey, Health Care Surveys, Practice Guidelines as Topic, MULTIDISCIPLINARY TEAMS, Rectal Neoplasms - pathology - surgery - therapy, business, Human, Abdominal surgery
Abstract

Law, WL is one of the members of the International Rectal Cancer Study Group, BACKGROUND: Little is known regarding variations in preoperative treatment and practice for rectal cancer (RC) on an international level, yet practice variation may result in differences in recurrence and survival rates. METHODS: One hundred seventy-three international colorectal centers were invited to participate in a survey of preoperative management of rectal cancer. RESULTS: One hundred twenty-three (71%) responded, with a majority of respondents from North America, Europe, and Asia. Ninety-three percent have more than 5 years' experience with rectal cancer surgery. Fifty-five percent use CT scan, 35% MRI, 29% ERUS, 12% digital rectal examination and 1% PET scan in all RC cases. Seventy-four percent consider threatened circumferential margin (CRM) an indication for neoadjuvant treatment. Ninety-two percent prefer 5-FU-based long-course neoadjuvant chemoradiation therapy (CRT). A significant difference in practice exists between the US and non-US surgeons: poor histological differentiation as an indication for CRT (25% vs. 7.0%, p = 0.008), CRT for stage II and III rectal cancer (92% vs. 43%, p = 0.0001), MRI for all RC patients (20% vs. 42%, p = 0.03), and ERUS for all RC patients (43% vs. 21%, p = 0.01). Multidisciplinary team meetings significantly influence decisions for MRI (RR = 3.62), neoadjuvant treatment (threatened CRM, RR = 5.67, stage II + III RR = 2.98), quality of pathology report (RR = 4.85), and sphincter-saving surgery (RR = 3.81). CONCLUSIONS: There was little consensus on staging, neoadjuvant treatment, and preoperative management of rectal cancer. Regular multidisciplinary team meetings influence decisions about neoadjuvant treatment and staging methods., published_or_final_version

Published
2010

91. Nomograms to predict survival and the risk for developing local or distant recurrence in patients with rectal cancer treated with optional short-term radiotherapy

Author

Van Gijn, W, Van Stiphout, Rgpm, Van De Velde, Cjh, Valentini, Vincenzo, Lammering, G, Gambacorta, Maria Antonietta, Påhlman, L, Bujko, K, Lambin, P., Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Van Gijn, W, Van Stiphout, Rgpm, Van De Velde, Cjh, Valentini, Vincenzo, Lammering, G, Gambacorta, Maria Antonietta, Påhlman, L, Bujko, K, Lambin, P., Valentini, Vincenzo (ORCID:0000-0003-4637-6487), and Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737)

Abstract

In many European countries, short-term 5 × 5 Gy radiotherapy has become the standard preoperative treatment of patients with resectable rectal cancer. Individualized risk assessment might allow a better selection of patients who will benefit from postoperative treatment and intensified follow-up.

Published
2015

97. Differences in pre-operative treatment for rectal cancer between Norway, Sweden, Denmark, Belgium and the Netherlands

Author

Van den Broek, C. B. M., van Gijn, W., Bastiaannet, E., Møller, B., Johansson, Robert, Elferink, M. A. G., Wibe, A., Påhlman, L., Iversen, L. H., Penninckx, F., Valentini, V., van de Velde, C. J. H., Van den Broek, C. B. M., van Gijn, W., Bastiaannet, E., Møller, B., Johansson, Robert, Elferink, M. A. G., Wibe, A., Påhlman, L., Iversen, L. H., Penninckx, F., Valentini, V., and van de Velde, C. J. H.

Abstract

Several studies have shown remarkable differences in colorectal cancer survival across Europe. Most of these studies lacked information about stage and treatment. In this study we compared short-term survival as well as differences in tumour stage and treatment strategies between five European countries: Norway, Sweden, Denmark, Belgium, and the Netherlands. For this retrospective cohort study all patients aged 18 years or older and operated on adenocarcinoma of the rectum without distant metastases and diagnosed in 2008 and 2009 were selected in national audit registries from Norway, Sweden, Denmark, Belgium, and the Netherlands. Differences in pre-operative treatment between the countries were compared using univariable and multivariable logistic regression. One year relative survival and one year relative excess risk of death (RER) were compared between the five countries. Large variation in the use of preoperative radiotherapy and chemoradiation was found between the countries. Even though, there was little variation in relative survival between the countries, except Sweden, which had a significant better one year RER of death among the elderly patients after adjustment. The differences in survival are expected to be caused by differences in pen-operative care, selection of patients, and especially management of elderly patients. The effects of preoperative treatment are expected to be seen on long term follow-up.

Published
2014
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98. EURECCA colorectal: multidisciplinary management: European consensus conference colon & rectum

Author

Van De Velde, Cjh, Boelens, Pg, Borras, Jm, Coebergh, J, Cervantes, A, Blomqvist, L, Beets Tan, Rgh, Van Den Broek, Cbm, Brown, G, Van Cutsem, E, Espin, E, Haustermans, K, Glimelius, B, Iversen, Lh, Van Krieken, Jh, Marijnen, Cam, Henning, G, Gore Booth, J, Meldolesi, Elisa, Mroczkowski, P, Nagtegaal, I, Naredi, P, Ortiz, H, Påhlman, L, Quirke, P, Rödel, C, Roth, A, Rutten, H, Schmoll, Hj, Smith, Jj, Tanis, Pj, Taylor, C, Wibe, A, Wiggers, T, Gambacorta, Maria Antonietta, Aristei, C, Valentini, Vincenzo, Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Van De Velde, Cjh, Boelens, Pg, Borras, Jm, Coebergh, J, Cervantes, A, Blomqvist, L, Beets Tan, Rgh, Van Den Broek, Cbm, Brown, G, Van Cutsem, E, Espin, E, Haustermans, K, Glimelius, B, Iversen, Lh, Van Krieken, Jh, Marijnen, Cam, Henning, G, Gore Booth, J, Meldolesi, Elisa, Mroczkowski, P, Nagtegaal, I, Naredi, P, Ortiz, H, Påhlman, L, Quirke, P, Rödel, C, Roth, A, Rutten, H, Schmoll, Hj, Smith, Jj, Tanis, Pj, Taylor, C, Wibe, A, Wiggers, T, Gambacorta, Maria Antonietta, Aristei, C, Valentini, Vincenzo, Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)

Abstract

Care for patients with colon and rectal cancer has improved in the last 20years; however considerable variation still exists in cancer management and outcome between European countries. Large variation is also apparent between national guidelines and patterns of cancer care in Europe. Therefore, EURECCA, which is the acronym of European Registration of Cancer Care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012, the first multidisciplinary consensus conference about cancer of the colon and rectum was held. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries.

Published
2014

99. Differences in pre-operative treatment for rectal cancer between Norway, Sweden, Denmark, Belgium and the Netherlands

Author

Van Den Broek, Cbm, Van Gijn, W, Bastiaannet, E, Møller, B, Johansson, R, Elferink, Mag, Wibe, A, Påhlman, L, Iversen, Lh, Penninckx, F, Valentini, Vincenzo, Van De Velde, Cjh, Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Van Den Broek, Cbm, Van Gijn, W, Bastiaannet, E, Møller, B, Johansson, R, Elferink, Mag, Wibe, A, Påhlman, L, Iversen, Lh, Penninckx, F, Valentini, Vincenzo, Van De Velde, Cjh, and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)

Abstract

Several studies have shown remarkable differences in colorectal cancer survival across Europe. Most of these studies lacked information about stage and treatment. In this study we compared short-term survival as well as differences in tumour stage and treatment strategies between five European countries: Norway, Sweden, Denmark, Belgium, and the Netherlands. For this retrospective cohort study all patients aged 18 years or older and operated on adenocarcinoma of the rectum without distant metastases and diagnosed in 2008 and 2009 were selected in national audit registries from Norway, Sweden, Denmark, Belgium, and the Netherlands. Differences in pre-operative treatment between the countries were compared using univariable and multivariable logistic regression. One year relative survival and one year relative excess risk of death (RER) were compared between the five countries. Large variation in the use of preoperative radiotherapy and chemoradiation was found between the countries. Even though, there was little variation in relative survival between the countries, except Sweden, which had a significant better one year RER of death among the elderly patients after adjustment. The differences in survival are expected to be caused by differences in peri-operative care, selection of patients, and especially management of elderly patients. The effects of preoperative treatment are expected to be seen on long term follow-up.

Published
2014

100. Pharmacodynamic aspects of intraperitoneal cytotoxic therapy

Author

wim ceelen, Påhlman L, and Mahteme H

Subjects
Chemotherapy, Cancer, Regional Perfusion, Neoplasms, Animals, Humans, Antineoplastic Agents, Infusions, Parenteral, Tissue Distribution, Hyperthermia, Induced, Peritoneum
Abstract

The rationale for ip administration as an adjunct to surgery is firmly based on theoretical and pharmacokinetic grounds. The superiority of combined ip and intravenous chemotherapy over intravenous chemotherapy alone has been established in randomized trials in stage IIIc ovarian cancer patients. Intraoperative ip cytotoxic therapy results in a definite pharmacological advantage, since high peritoneal concentrations are achieved with limited systemic absorption. At present, however, it is not clearly established to what extent this PK advantage will result in enhanced anticancer activity and, ultimately, in a survival benefit. Preclinical models show that direct penetration into tumour tissue is limited to a few millimeters. Furthermore, the limited exposure time of intraoperative chemoperfusion could limit cytotoxic activity despite high local concentrations. Among the cytotoxic agents currently used, the pharmacodynamic aspects of the platinum compounds are the best studied both with and without associated hyperthermia. Newer agents such as the taxanes and the camptothecins appear promising for ip chemoperfusion during or immediately after surgery. Pharmacodynamic aspects of HIPEC needing further preclinical study-including mathematical modeling - are the establishment of tumour tissue penetration of the newer agents and its relation to hyperthermia, the definition of the relative contribution of direct penetration versus vascular supply by absorbed drug, and the efficacy of combined ip and intravenous regimens. Ultimately, however, randomised trials of ip chemotherapy with surgery will have to provide the evidence base to further build upon.

Published
2007

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