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1. Standardization of the definition of the types of oncological colectomy. Delphi method for consensus of experts of the Spanish Association of Surgeons

Author

Die-Trill, J., Pascual Damieta, P., Peña Ros, E., Jimenez Rodríguez, R., Hidalgo Pujol, M., Jiménez Gómez, L.M., Arencibia Pérez, B., Vigorita, V., Colombari, R., Pérez Pérez, T., García Martínez, M.T., Bauxali, J., Cerdán, J., García-Pérez, J.C., Martin-Perez, B., Uribe Quintana, N., Farrés Coll, R., González-Argenté, F.J., Bernal Sprekelsen, J.C., Fraccalvieri, D., Garcia Granero, E., Gómez Ruiz, M., García Cabrera, A.M., Palma, P., Pla-Martí, V., Mera Velasco, S., Blanco-Antona, F., Parajó, A., Salgado, G., Vázquez Monchul, J.M., Ocaña Jiménez, J., Jiménez-Escobar, F., Martí-Gallostra, M., Díaz Pavón, J.M., Salvador-Morales, C., Biondo, S., Espí, A., Solana-Bueno, A., Marín, G., Pastor Idoate, C., Valle-Hernández, E.D., Tejedor, P., Alós Company, R., Elosua, T., Rueda Orgaz, J.A., García Septiem, J., Ballester Ibánez, C., Frasson, M., Hernandis Villalba, J.V., Pascual Miguelañez, I., García-González, J.M., Jimenez-Toscano, M., Benavides Buleje, J.A., Enríquez-Navascués, J.M., Reyes Díaz, M.L., Millan, M., Sánchez-Guillén, L., Roig Vila, J.V., Parra-Baños, P.A., Fernánde, C., Cantero-Cid, R., Truán Alonso, N., Nogués-Ramia, E.M., Serra Pla, S., Climent-Agustín, M., Marinello, F., Moro-Valdezate, D., Frago, R., Espin, E., Pera-Román, M., Álvarez Laso, C.J., Placer-Galan, C., Labalde Martínez, M., García-Armengol, J.J., Codina, A., Capitan-Morales, L.C., Garcia-Aguilar, J., Fernández-Cebrián, J.M., Fernández-Hevia, M., García-Flórez, L.J., Pellino, G., Martínez-Pérez, C., Fernández-López, F., Garcia-Granero, Alvaro, Martín-Martín, Gonzalo P., Dujovne-Lindenbaum, Paula, Alvarez Laso, Carlos J., Cerdán-Santacruz, Carlos, Flor-Lorente, Blas, and Biondo, Sebastiano

Published
2024
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2. Estandarización de la definición de los tipos de colectomía oncológica. Método Delphi para consenso de expertos de la Asociación Española de Cirujanos

Author

Die-Trill, J., Pascual Damieta, P., Peña Ros, E., Jimenez Rodríguez, R., Hidalgo Pujol, M., Jiménez Gómez, L.M., Arencibia Pérez, B., Vigorita, V., Colombari, R., Pérez Pérez, T., García Martínez, M.T., Bauxali, J., Cerdán, J., García-Pérez, J.C., Martin-Perez, B., Uribe Quintana, N., Farrés Coll, R., González-Argenté, F.J., Bernal Sprekelsen, J.C., Fraccalvieri, D., Garcia Granero, E., Gómez Ruiz, M., García Cabrera, A.M., Palma, P., Pla-Martí, V., Mera Velasco, S., Blanco-Antona, F., Parajó, A., Salgado, G., Vázquez Monchul, J.M., Ocaña Jiménez, J., Jiménez-Escobar, F., Martí-Gallostra, M., Díaz Pavón, J.M., Salvador-Morales, C., Biondo, S., Espí, A., Solana-Bueno, A., Marín, G., Pastor Idoate, C., Valle-Hernández, E.D., Tejedor, P., Alós Company, R., Elosua, T., Rueda Orgaz, J.A., García Septiem, J., Ballester Ibánez, C., Frasson, M., Hernandis Villalba, J.V., Pascual Miguelañez, I., García-González, J.M., Jimenez-Toscano, M., Benavides Buleje, J.A., Enríquez-Navascués, J.M., Reyes Díaz, M.L., Millan, M., Sánchez-Guillén, L., Roig Vila, J.V., Parra-Baños, P.A., Fernánde, C., Cantero-Cid, R., Truán Alonso, N., Nogués-Ramia, E.M., Serra Pla, S., Climent-Agustín, M., Marinello, F., Moro-Valdezate, D., Frago, R., Espin, E., Pera-Román, M., Álvarez Laso, C.J., Placer-Galan, C., Labalde Martínez, M., García-Armengol, J.J., Codina, A., Capitan-Morales, L.C., Garcia-Aguilar, J., Fernández-Cebrián, J.M., Fernández-Hevia, M., García-Flórez, L.J., Pellino, G., Martínez-Pérez, C., Fernández-López, F., Garcia-Granero, Alvaro, Martín-Martín, Gonzalo P, Dujovne-Lindenbaum, Paula, Alvarez Laso, Carlos J, Cerdán-Santacruz, Carlos, Flor-Lorente, Blas, and Biondo, Sebastiano

Published
2024
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4. Short-term outcomes of chemoradiotherapy and local excision versus total mesorectal excision in T2-T3ab,N0,M0 rectal cancer: a multicentre randomised, controlled, phase III trial (the TAU-TEM study)

Author

Serra-Aracil, X., Pericay, C., Badia-Closa, J., Golda, T., Biondo, S., Hernández, P., Targarona, E., Borda-Arrizabalaga, N., Reina, A., Delgado, S., Vallribera, F., Caro, A., Gallego-Plazas, J., Pascual, M., Álvarez-Laso, C., Guadalajara-Labajo, H.G., and Mora-Lopez, L.

Published
2023
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6. Effect of centre volume on pathological outcomes and postoperative complications after surgery for colorectal cancer: results of a multicentre national study

Author

Rottoli, M, Spinelli, A, Pellino, G, Gori, A, Calini, G, Flacco, M, Manzoli, L, Poggioli, G, Romano, A, Belvedere, A, Lanci, A, Parlanti, D, Vago, G, Pezzuto, A, Canavese, A, Dajti, G, Cardelli, S, Catalioto, C, Russo, I, Violante, T, Morezzi, D, Maurino, L, Filippone, E, Cuicchi, D, Bernante, P, Jovine, E, Lombardi, R, Masetti, M, Cipressi, C, Offi, M, Larotonda, C, Puglisi, S, Barbosa, A, Vaiana, R, Bianchi, P, Tonti, C, Codignola, C, Zorcolo, L, Restivo, A, Deidda, S, Marchetti, M, Ippolito, L, Spolverato, G, Pucciarelli, S, Marchegiani, F, Ghio, G, Zagolin, G, Glavas, D, Tomassi, M, Rosati, R, Elmore, U, Gozzini, L, Calef, R, Puccetti, F, Cossu, A, Vignali, A, Morino, M, Allaix, M, Cannata, G, Lombardi, E, Ammirati, C, Piceni, C, Buccianti, P, Balestri, R, Puccini, M, Pezzati, D, D'Ischia, R, Asta, V, Sargenti, B, Taddei, G, Bonari, F, Boni, G, Ferrero, A, Mineccia, M, Gonella, F, Palisi, M, Danese, F, Cherubini, V, Perotti, S, Carvello, M, Carbone, F, Luberto, A, Calafiore, E, De Lucia, F, Sacchi, M, Sasia, D, Giuffrida, M, Ballauri, E, Cardile, M, Armentano, S, Beltrami, E, Preve, G, Vercellone, B, Mozzon, M, Folliero, C, Lirusso, C, Vecchiato, M, Ziccarelli, A, Gattesco, D, Moretti, L, Crestale, S, Banchini, F, Capelli, P, Romboli, A, Palmieri, G, Conti, L, Rizzi, N, Bonfili, D, De Manzini, N, Germani, P, Osenda, E, Cortinovis, S, Giunta, C, Fracon, S, Abdallah, H, Bogoni, S, Portolani, N, Nascimbeni, R, Molfino, S, Tiberio, G, Garosio, I, Lamperti, G, Rigosa, D, Ercolani, G, Solaini, L, Cavaliere, D, Avanzolini, A, D'Acapito, F, Chiarella, L, Di Pietrantonio, D, Annunziata, D, Piccolo, R, Sorrentino, M, Pansini, M, Cojutti, A, Graziano, M, Callegari, F, Balzarotti, L, Dameno, V, Cattaneo, A, Santolamazza, G, Altieri, C, Magarini, R, Pietrabissa, A, Dominioni, T, Pugliese, L, Peri, A, Botti, M, Salvetti, F, Boni, L, Cassinotti, E, Baldari, L, Messina, V, D'Abrosca, V, Cianci, P, Tumolo, R, Gattulli, D, Restini, E, Minafra, M, Sederino, M, Bottalico, B, Pilati, P, Franzato, B, Mattara, G, De Simoni, O, Barina, A, Tonello, M, Muratore, A, Calabro, M, Federico Pipitone, N, Cuzzola, B, Van Nood, E, Passuello, N, Frasson, A, Mammano, E, Faccio, L, Vittadello, F, Bressan, A, Sarzo, G, Tamini, N, Oldani, M, Cigagna, L, Carissimi, F, De Carlo, G, Baccalini, E, Nespoli, L, Giordano, A, Cantafio, S, Grifoni, L, Matani, D, Livi, S, Delogu, D, Scognamillo, F, Marrosu, A, Guerrini, L, Ugolini, G, Ghignone, F, Frascaroli, G, Albertini, N, Zattoni, D, Taffurelli, G, Montroni, I, Colombo, F, Danelli, P, Bondurri, A, Maffioli, A, Bonomi, A, Pezzoli, I, Cammarata, F, Goletti, O, Molteni, M, Assisi, A, Quartierini, G, Da Lio, C, Verdi, D, Mondi, I, Peluso, C, Macchi, L, Tanzanu, M, Zanzi, F, Pellegrini, S, Andreuccetti, J, D'Alessio, R, Pignata, G, De Capua, M, Canfora, I, Ottaviani, L, Lepiane, P, Balla, A, De Carlo, A, Saraceno, F, Scaramuzzo, R, Guida, A, Aguzzi, D, Bellora, P, Gentilli, S, Monni, M, Nikaj, H, Cillara, N, Cannavera, A, Deserra, A, Margiani, C, Cabula, R, Dettori, M, Gramignano, G, Lezoche, G, Ortenzi, M, Orlandoni, E, Curzi, F, Vitali, F, Capomagi, P, Palmieri, M, Del Rio, P, Bonati, E, Loderer, T, Cozzani, F, Rossini, M, Agnesi, S, Capolupo, G, Caricato, M, Carannante, F, Masciana, G, Marrelli, M, Miacci, V, Lauricella, S, Tonini, V, Cervellera, M, Pisconti, S, Lozito, C, Shahu, J, Mongelli, C, Morelli, G, Sartarelli, L, Sica, G, Siragusa, L, Bagaglini, G, Franceschilli, M, Bellato, V, Fiorani, C, Taddei, A, Risaliti, M, Bartolini, I, Ringressi, M, Tirloni, L, Laface, L, Abate, E, Casati, M, Gobbi, P, Opocher, E, Mariani, N, Ceretti, A, Giovenzana, M, Giuliani, B, Sironi, M, Grossi, U, Zanus, G, Santoro, G, Brizzolari, M, De Leo, E, Novello, S, Aquilino, K, Milardi, F, Olmi, S, Uccelli, M, Bonaldi, M, Cesana, G, Bindi, M, Galleano, R, Langone, A, Botto, M, Franceschi, A, Gambino, E, Ronconi, M, Casiraghi, S, Casole, G, Ciulla, S, Terrosu, G, Calandra, S, Scarpa, E, Cherchi, V, Martinuzzo, L, Clocchiatti, L, Muschitiello, D, Romanzi, A, Vignati, B, Vannelli, A, Scolaro, R, Milanesi, M, Rossi, F, Canonico, G, Anastasi, A, Nelli, T, Barlettai, M, Fratarcangeli, R, Di Martino, C, Damigella, A, Adinolfi, E, Birindelli, A, Taglietti, L, Dester, S, Fleres, F, Cucinotta, E, Viscosi, F, Biondo, S, Badessi, G, Catarsini, N, Mazzeo, C, Rega, D, Delrio, P, Cervone, C, Aversano, A, De Franciscis, S, Di Marzo, M, Marra, B, Pace, U, Amato, A, Batistotti, P, Mina, E, Serventi, A, Lapolla, P, Mingoli, A, Sapienza, P, Brachini, G, Cirillo, B, Fiori, E, Crocetti, D, Clementi, I, Martines, G, Picciariello, A, Tomasicchio, G, Dibra, R, Trigiante, G, Rinaldi, M, Lantone, G, Porcu, A, Perra, T, Scanu, A, Feo, C, Fancellu, A, Cossu, M, Ginesu, G, Patriti, A, Coletta, D, Petrelli, F, Greco, P, Spadoni, C, Cassiani, G, Bianchini, F, Arganini, M, Bianchini, M, Perotti, B, Palmeri, M, Scabini, S, Deiana, S, Carganico, G, Pertile, D, Soriero, D, Fioravanti, E, Sperotto, B, Nardo, B, Paglione, D, Crocco, V, Doni, M, Osso, M, Perri, R, Sampietro, G, Corbellini, C, Lorusso, L, Manzo, C, Cigognini, M, Baldi, C, Palomba, G, Aprea, G, Capuano, M, Basile, R, Tutino, R, Massani, M, Marinelli, L, Canitano, N, Pilia, T, Podda, M, Pisanu, A, Murzi, V, Incani, S, Frongia, F, Esposito, G, Luglio, G, Tropeano, F, Pagano, G, Spina, E, De Simone, G, Cricri, M, Catena, F, Vallicelli, C, Zanini, N, Ronconi, D, Favi, F, Mazzucchelli, C, Convertini, G, Vincenti, L, Andriola, V, Bizzoca, C, Fabbri, N, Fazzin, M, Pesce, A, Gennari, S, Torchiaro, M, Severi, S, Frontali, A, Bracchetti, G, Granieri, S, Cotsoglou, C, Carlini, M, Lisi, G, Spoletini, D, Mastrangeli, M, Campanelli, M, Manigrasso, M, Milone, M, De Palma, G, Vertaldi, S, Chini, A, Maione, F, Marello, A, Selvaggi, F, Sciaudone, G, Selvaggi, L, Tasselli, F, Fuschillo, G, Oddis, L, Grande, S, Grande, M, Ascanelli, S, Chimisso, L, Aisoni, F, Rossin, E, Pepe, F, Marchetti, F, Picardi, B, Rossi, S, Del Monte, S, Picarelli, M, Muttillo, I, Ratto, C, Marra, A, Parello, A, Litta, F, Campenni, P, De Simone, V, Pata, F, Riboni, C, Rausa, E, Celentano, V, Rottoli M., Spinelli A., Pellino G., Gori A., Calini G., Flacco M. E., Manzoli L., Poggioli G., Romano A., Belvedere A., Lanci A. L., Parlanti D., Vago G., Pezzuto A. P., Canavese A., Dajti G., Cardelli S., Catalioto C., Russo I. S., Violante T., Morezzi D., Maurino L., Filippone E., Cuicchi D., Bernante P., Jovine E., Lombardi R., Masetti M., Cipressi C., Offi M. F., Larotonda C., Puglisi S. B., Barbosa A., Vaiana R., Bianchi P. M., Tonti C., Codignola C., Zorcolo L., Restivo A., Deidda S., Marchetti M. E., Ippolito L., Spolverato G., Pucciarelli S., Marchegiani F., Ghio G., Zagolin G., Glavas D., Tomassi M., Rosati R., Elmore U., Gozzini L., Calef R., Puccetti F., Cossu A., Vignali A., Morino M., Allaix M. E., Cannata G., Lombardi E., Ammirati C. A., Piceni C., Buccianti P., Balestri R., Puccini M., Pezzati D., D'Ischia R., Asta V. F., Sargenti B., Taddei G., Bonari F., Boni G., Ferrero A., Mineccia M., Gonella F., Palisi M., Danese F., Cherubini V., Perotti S., Carvello M., Carbone F., Luberto A., Calafiore E., De Lucia F., Sacchi M., Sasia D., Giuffrida M. C., Ballauri E., Cardile M., Armentano S., Beltrami E., Preve G., Vercellone B., Mozzon M., Folliero C., Lirusso C., Vecchiato M., Ziccarelli A., Gattesco D., Moretti L., Crestale S., Banchini F., Capelli P., Romboli A., Palmieri G., Conti L., Rizzi N., Bonfili D., De Manzini N., Germani P., Osenda E., Cortinovis S., Giunta C., Fracon S., Abdallah H., Bogoni S., Portolani N., Nascimbeni R., Molfino S., Tiberio G. A. M., Garosio I., Lamperti G., Rigosa D., Ercolani G., Solaini L., Cavaliere D., Avanzolini A., D'Acapito F., Chiarella L. L., Di Pietrantonio D., Annunziata D., Piccolo R., Sorrentino M., Pansini M., Cojutti A., Graziano M., Callegari F., Balzarotti L., Dameno V. R., Cattaneo A., Santolamazza G., Altieri C., Magarini R., Pietrabissa A., Dominioni T., Pugliese L., Peri A., Botti M., Salvetti F., Boni L., Cassinotti E., Baldari L., Messina V., D'Abrosca V., Cianci P., Tumolo R., Gattulli D., Restini E., Minafra M., Sederino M. G., Bottalico B., Pilati P., Franzato B., Mattara G., De Simoni O., Barina A., Tonello M., Muratore A., Calabro M., Federico Pipitone N. S., Cuzzola B., Van Nood E. H., Passuello N., Frasson A., Mammano E., Faccio L., Vittadello F., Bressan A., Sarzo G., Tamini N., Oldani M., Cigagna L., Carissimi F., De Carlo G., Baccalini E., Nespoli L., Giordano A., Cantafio S., Grifoni L., Matani D., Livi S., Delogu D., Scognamillo F., Marrosu A., Guerrini L., Ugolini G., Ghignone F., Frascaroli G., Albertini N., Zattoni D., Taffurelli G., Montroni I., Colombo F., Danelli P., Bondurri A., Maffioli A., Bonomi A., Pezzoli I., Cammarata F., Goletti O., Molteni M., Assisi A., Quartierini G., Da Lio C., Verdi D., Mondi I., Peluso C., MacChi L., Tanzanu M., Zanzi F., Pellegrini S., Andreuccetti J., D'Alessio R., Pignata G., De Capua M., Canfora I., Ottaviani L., Lepiane P., Balla A., De Carlo A., Saraceno F., Scaramuzzo R., Guida A., Aguzzi D., Bellora P., Gentilli S., Monni M., Nikaj H., Cillara N., Cannavera A., Deserra A., Margiani C., Cabula R., Dettori M., Gramignano G., Lezoche G., Ortenzi M., Orlandoni E. S., Curzi F., Vitali F., Capomagi P., Palmieri M., Giuffrida M., Del Rio P., Bonati E., Loderer T., Cozzani F., Rossini M., Agnesi S., Capolupo G. T., Caricato M., Carannante F., Masciana G., Marrelli M., Miacci V., Lauricella S., Tonini V., Cervellera M., Pisconti S., Lozito C., Shahu J., Mongelli C., Morelli G., Sartarelli L., Sica G. S., Siragusa L., Bagaglini G., Guida A. M., Franceschilli M., Bellato V., Fiorani C., Taddei A., Risaliti M., Bartolini I., Ringressi M. N., Tirloni L., Laface L., Abate E., Casati M., Gobbi P., Opocher E., Mariani N. M., Ceretti A. P., Giovenzana M., Giuliani B., Sironi M., Grossi U., Zanus G., Santoro G. A., Brizzolari M., De Leo E., Novello S., Aquilino K., Milardi F., Olmi S., Uccelli M., Bonaldi M., Cesana G. C., Bindi M., Galleano R., Langone A., Botto M., Franceschi A., Gambino E., Ronconi M., Casiraghi S., Casole G., Ciulla S. L., Terrosu G., Calandra S., Scarpa E., Cherchi V., Martinuzzo L., Clocchiatti L., Muschitiello D., Romanzi A., Vignati B., Vannelli A., Scolaro R., Milanesi M., Rossi F., Canonico G., Anastasi A., Nelli T., Barlettai M., Fratarcangeli R., Di Martino C., Damigella A., Adinolfi E., Birindelli A., Taglietti L., Dester S. E., Fleres F., Cucinotta E., Viscosi F., Biondo S. A., Badessi G., Catarsini N., Mazzeo C., Rega D., Delrio P., Cervone C., Aversano A., De Franciscis S., Di Marzo M., Marra B., Pace U., Amato A., Batistotti P., Mina E., Serventi A., Lapolla P., Mingoli A., Sapienza P., Brachini G., Cirillo B., Fiori E., Crocetti D., Clementi I., Martines G., Picciariello A., Tomasicchio G., Dibra R., Trigiante G., Rinaldi M., Lantone G., Porcu A., Perra T., Scanu A. M., Feo C. F., Fancellu A., Cossu M. L., Ginesu G. C., Patriti A., Coletta D., Petrelli F., Greco P. A., Spadoni C., Cassiani G., Bianchini F., Arganini M., Bianchini M., Perotti B., Palmeri M., Scabini S., Deiana S., Carganico G., Pertile D., Soriero D., Fioravanti E., Sperotto B., Nardo B., Paglione D., Crocco V., Doni M., Osso M., Perri R., Sampietro G. M., Corbellini C., Lorusso L., Manzo C. A., Cigognini M., Baldi C., Palomba G., Aprea G., Capuano M., Basile R., Tutino R., Massani M., Marinelli L., Canitano N., Pilia T., Podda M., Pisanu A., Murzi V., Incani S., Frongia F., Esposito G., Luglio G., Tropeano F. P., Pagano G., Spina E., De Simone G., Cricri M., Catena F., Vallicelli C., Zanini N., Ronconi D., Favi F., Mazzucchelli C., Convertini G., Vincenti L., Andriola V., Bizzoca C., Feo C. V., Fabbri N., Fazzin M., Pesce A., Gennari S., Torchiaro M., Severi S., Frontali A., Bracchetti G., Granieri S., Cotsoglou C., Carlini M., Lisi G., Spoletini D., Mastrangeli M. R., Campanelli M., Manigrasso M., Milone M., De Palma G. D., Vertaldi S., Chini A., Maione F., Marello A., Selvaggi F., Sciaudone G., Selvaggi L., Tasselli F. M., Fuschillo G., Oddis L., Grande S., Grande M., Ascanelli S., Chimisso L., Aisoni F., Rossin E., Pepe F., Marchetti F., Picardi B., Rossi S., Del Monte S. R., Picarelli M., Muttillo I. A., Ratto C., Marra A. A., Parello A., Litta F., Campenni P., De Simone V., Pata F., Riboni C., Rausa E., Celentano V., Rottoli, M, Spinelli, A, Pellino, G, Gori, A, Calini, G, Flacco, M, Manzoli, L, Poggioli, G, Romano, A, Belvedere, A, Lanci, A, Parlanti, D, Vago, G, Pezzuto, A, Canavese, A, Dajti, G, Cardelli, S, Catalioto, C, Russo, I, Violante, T, Morezzi, D, Maurino, L, Filippone, E, Cuicchi, D, Bernante, P, Jovine, E, Lombardi, R, Masetti, M, Cipressi, C, Offi, M, Larotonda, C, Puglisi, S, Barbosa, A, Vaiana, R, Bianchi, P, Tonti, C, Codignola, C, Zorcolo, L, Restivo, A, Deidda, S, Marchetti, M, Ippolito, L, Spolverato, G, Pucciarelli, S, Marchegiani, F, Ghio, G, Zagolin, G, Glavas, D, Tomassi, M, Rosati, R, Elmore, U, Gozzini, L, Calef, R, Puccetti, F, Cossu, A, Vignali, A, Morino, M, Allaix, M, Cannata, G, Lombardi, E, Ammirati, C, Piceni, C, Buccianti, P, Balestri, R, Puccini, M, Pezzati, D, D'Ischia, R, Asta, V, Sargenti, B, Taddei, G, Bonari, F, Boni, G, Ferrero, A, Mineccia, M, Gonella, F, Palisi, M, Danese, F, Cherubini, V, Perotti, S, Carvello, M, Carbone, F, Luberto, A, Calafiore, E, De Lucia, F, Sacchi, M, Sasia, D, Giuffrida, M, Ballauri, E, Cardile, M, Armentano, S, Beltrami, E, Preve, G, Vercellone, B, Mozzon, M, Folliero, C, Lirusso, C, Vecchiato, M, Ziccarelli, A, Gattesco, D, Moretti, L, Crestale, S, Banchini, F, Capelli, P, Romboli, A, Palmieri, G, Conti, L, Rizzi, N, Bonfili, D, De Manzini, N, Germani, P, Osenda, E, Cortinovis, S, Giunta, C, Fracon, S, Abdallah, H, Bogoni, S, Portolani, N, Nascimbeni, R, Molfino, S, Tiberio, G, Garosio, I, Lamperti, G, Rigosa, D, Ercolani, G, Solaini, L, Cavaliere, D, Avanzolini, A, D'Acapito, F, Chiarella, L, Di Pietrantonio, D, Annunziata, D, Piccolo, R, Sorrentino, M, Pansini, M, Cojutti, A, Graziano, M, Callegari, F, Balzarotti, L, Dameno, V, Cattaneo, A, Santolamazza, G, Altieri, C, Magarini, R, Pietrabissa, A, Dominioni, T, Pugliese, L, Peri, A, Botti, M, Salvetti, F, Boni, L, Cassinotti, E, Baldari, L, Messina, V, 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Carganico, G, Pertile, D, Soriero, D, Fioravanti, E, Sperotto, B, Nardo, B, Paglione, D, Crocco, V, Doni, M, Osso, M, Perri, R, Sampietro, G, Corbellini, C, Lorusso, L, Manzo, C, Cigognini, M, Baldi, C, Palomba, G, Aprea, G, Capuano, M, Basile, R, Tutino, R, Massani, M, Marinelli, L, Canitano, N, Pilia, T, Podda, M, Pisanu, A, Murzi, V, Incani, S, Frongia, F, Esposito, G, Luglio, G, Tropeano, F, Pagano, G, Spina, E, De Simone, G, Cricri, M, Catena, F, Vallicelli, C, Zanini, N, Ronconi, D, Favi, F, Mazzucchelli, C, Convertini, G, Vincenti, L, Andriola, V, Bizzoca, C, Fabbri, N, Fazzin, M, Pesce, A, Gennari, S, Torchiaro, M, Severi, S, Frontali, A, Bracchetti, G, Granieri, S, Cotsoglou, C, Carlini, M, Lisi, G, Spoletini, D, Mastrangeli, M, Campanelli, M, Manigrasso, M, Milone, M, De Palma, G, Vertaldi, S, Chini, A, Maione, F, Marello, A, Selvaggi, F, Sciaudone, G, Selvaggi, L, Tasselli, F, Fuschillo, G, Oddis, L, Grande, S, Grande, M, Ascanelli, S, Chimisso, L, Aisoni, F, Rossin, E, Pepe, F, Marchetti, F, Picardi, B, Rossi, S, Del Monte, S, Picarelli, M, Muttillo, I, Ratto, C, Marra, A, Parello, A, Litta, F, Campenni, P, De Simone, V, Pata, F, Riboni, C, Rausa, E, Celentano, V, Rottoli M., Spinelli A., Pellino G., Gori A., Calini G., Flacco M. E., Manzoli L., Poggioli G., Romano A., Belvedere A., Lanci A. L., Parlanti D., Vago G., Pezzuto A. P., Canavese A., Dajti G., Cardelli S., Catalioto C., Russo I. S., Violante T., Morezzi D., Maurino L., Filippone E., Cuicchi D., Bernante P., Jovine E., Lombardi R., Masetti M., Cipressi C., Offi M. F., Larotonda C., Puglisi S. B., Barbosa A., Vaiana R., Bianchi P. M., Tonti C., Codignola C., Zorcolo L., Restivo A., Deidda S., Marchetti M. E., Ippolito L., Spolverato G., Pucciarelli S., Marchegiani F., Ghio G., Zagolin G., Glavas D., Tomassi M., Rosati R., Elmore U., Gozzini L., Calef R., Puccetti F., Cossu A., Vignali A., Morino M., Allaix M. E., Cannata G., Lombardi E., Ammirati C. A., Piceni C., Buccianti P., Balestri R., Puccini M., Pezzati D., D'Ischia R., Asta V. F., Sargenti B., Taddei G., Bonari F., Boni G., Ferrero A., Mineccia M., Gonella F., Palisi M., Danese F., Cherubini V., Perotti S., Carvello M., Carbone F., Luberto A., Calafiore E., De Lucia F., Sacchi M., Sasia D., Giuffrida M. C., Ballauri E., Cardile M., Armentano S., Beltrami E., Preve G., Vercellone B., Mozzon M., Folliero C., Lirusso C., Vecchiato M., Ziccarelli A., Gattesco D., Moretti L., Crestale S., Banchini F., Capelli P., Romboli A., Palmieri G., Conti L., Rizzi N., Bonfili D., De Manzini N., Germani P., Osenda E., Cortinovis S., Giunta C., Fracon S., Abdallah H., Bogoni S., Portolani N., Nascimbeni R., Molfino S., Tiberio G. A. M., Garosio I., Lamperti G., Rigosa D., Ercolani G., Solaini L., Cavaliere D., Avanzolini A., D'Acapito F., Chiarella L. L., Di Pietrantonio D., Annunziata D., Piccolo R., Sorrentino M., Pansini M., Cojutti A., Graziano M., Callegari F., Balzarotti L., Dameno V. R., Cattaneo A., Santolamazza G., Altieri C., Magarini R., Pietrabissa A., Dominioni T., Pugliese L., Peri A., Botti M., Salvetti F., Boni L., Cassinotti E., Baldari L., Messina V., D'Abrosca V., Cianci P., Tumolo R., Gattulli D., Restini E., Minafra M., Sederino M. G., Bottalico B., Pilati P., Franzato B., Mattara G., De Simoni O., Barina A., Tonello M., Muratore A., Calabro M., Federico Pipitone N. S., Cuzzola B., Van Nood E. H., Passuello N., Frasson A., Mammano E., Faccio L., Vittadello F., Bressan A., Sarzo G., Tamini N., Oldani M., Cigagna L., Carissimi F., De Carlo G., Baccalini E., Nespoli L., Giordano A., Cantafio S., Grifoni L., Matani D., Livi S., Delogu D., Scognamillo F., Marrosu A., Guerrini L., Ugolini G., Ghignone F., Frascaroli G., Albertini N., Zattoni D., Taffurelli G., Montroni I., Colombo F., Danelli P., Bondurri A., Maffioli A., Bonomi A., Pezzoli I., Cammarata F., Goletti O., Molteni M., Assisi A., Quartierini G., Da Lio C., Verdi D., Mondi I., Peluso C., MacChi L., Tanzanu M., Zanzi F., Pellegrini S., Andreuccetti J., D'Alessio R., Pignata G., De Capua M., Canfora I., Ottaviani L., Lepiane P., Balla A., De Carlo A., Saraceno F., Scaramuzzo R., Guida A., Aguzzi D., Bellora P., Gentilli S., Monni M., Nikaj H., Cillara N., Cannavera A., Deserra A., Margiani C., Cabula R., Dettori M., Gramignano G., Lezoche G., Ortenzi M., Orlandoni E. S., Curzi F., Vitali F., Capomagi P., Palmieri M., Giuffrida M., Del Rio P., Bonati E., Loderer T., Cozzani F., Rossini M., Agnesi S., Capolupo G. T., Caricato M., Carannante F., Masciana G., Marrelli M., Miacci V., Lauricella S., Tonini V., Cervellera M., Pisconti S., Lozito C., Shahu J., Mongelli C., Morelli G., Sartarelli L., Sica G. S., Siragusa L., Bagaglini G., Guida A. M., Franceschilli M., Bellato V., Fiorani C., Taddei A., Risaliti M., Bartolini I., Ringressi M. N., Tirloni L., Laface L., Abate E., Casati M., Gobbi P., Opocher E., Mariani N. M., Ceretti A. P., Giovenzana M., Giuliani B., Sironi M., Grossi U., Zanus G., Santoro G. A., Brizzolari M., De Leo E., Novello S., Aquilino K., Milardi F., Olmi S., Uccelli M., Bonaldi M., Cesana G. C., Bindi M., Galleano R., Langone A., Botto M., Franceschi A., Gambino E., Ronconi M., Casiraghi S., Casole G., Ciulla S. L., Terrosu G., Calandra S., Scarpa E., Cherchi V., Martinuzzo L., Clocchiatti L., Muschitiello D., Romanzi A., Vignati B., Vannelli A., Scolaro R., Milanesi M., Rossi F., Canonico G., Anastasi A., Nelli T., Barlettai M., Fratarcangeli R., Di Martino C., Damigella A., Adinolfi E., Birindelli A., Taglietti L., Dester S. E., Fleres F., Cucinotta E., Viscosi F., Biondo S. A., Badessi G., Catarsini N., Mazzeo C., Rega D., Delrio P., Cervone C., Aversano A., De Franciscis S., Di Marzo M., Marra B., Pace U., Amato A., Batistotti P., Mina E., Serventi A., Lapolla P., Mingoli A., Sapienza P., Brachini G., Cirillo B., Fiori E., Crocetti D., Clementi I., Martines G., Picciariello A., Tomasicchio G., Dibra R., Trigiante G., Rinaldi M., Lantone G., Porcu A., Perra T., Scanu A. M., Feo C. F., Fancellu A., Cossu M. L., Ginesu G. C., Patriti A., Coletta D., Petrelli F., Greco P. A., Spadoni C., Cassiani G., Bianchini F., Arganini M., Bianchini M., Perotti B., Palmeri M., Scabini S., Deiana S., Carganico G., Pertile D., Soriero D., Fioravanti E., Sperotto B., Nardo B., Paglione D., Crocco V., Doni M., Osso M., Perri R., Sampietro G. M., Corbellini C., Lorusso L., Manzo C. A., Cigognini M., Baldi C., Palomba G., Aprea G., Capuano M., Basile R., Tutino R., Massani M., Marinelli L., Canitano N., Pilia T., Podda M., Pisanu A., Murzi V., Incani S., Frongia F., Esposito G., Luglio G., Tropeano F. P., Pagano G., Spina E., De Simone G., Cricri M., Catena F., Vallicelli C., Zanini N., Ronconi D., Favi F., Mazzucchelli C., Convertini G., Vincenti L., Andriola V., Bizzoca C., Feo C. V., Fabbri N., Fazzin M., Pesce A., Gennari S., Torchiaro M., Severi S., Frontali A., Bracchetti G., Granieri S., Cotsoglou C., Carlini M., Lisi G., Spoletini D., Mastrangeli M. R., Campanelli M., Manigrasso M., Milone M., De Palma G. D., Vertaldi S., Chini A., Maione F., Marello A., Selvaggi F., Sciaudone G., Selvaggi L., Tasselli F. M., Fuschillo G., Oddis L., Grande S., Grande M., Ascanelli S., Chimisso L., Aisoni F., Rossin E., Pepe F., Marchetti F., Picardi B., Rossi S., Del Monte S. R., Picarelli M., Muttillo I. A., Ratto C., Marra A. A., Parello A., Litta F., Campenni P., De Simone V., Pata F., Riboni C., Rausa E., and Celentano V.

Abstract

Background: The association between volume, complications and pathological outcomes is still under debate regarding colorectal cancer surgery. The aim of the study was to assess the association between centre volume and severe complications, mortality, less-than-radical oncologic surgery, and indications for neoadjuvant therapy. Methods: Retrospective analysis of 16,883 colorectal cancer cases from 80 centres (2018-2021). Outcomes: 30-day mortality; Clavien-Dindo grade >2 complications; removal of ≥ 12 lymph nodes; non-radical resection; neoadjuvant therapy. Quartiles of hospital volumes were classified as LOW, MEDIUM, HIGH, and VERY HIGH. Independent predictors, both overall and for rectal cancer, were evaluated using logistic regression including age, gender, AJCC stage and cancer site. Results: LOW-volume centres reported a higher rate of severe postoperative complications (OR 1.50, 95% c.i. 1.15-1.096, P = 0.003). The rate of ≥ 12 lymph nodes removed in LOW-volume (OR 0.68, 95% c.i. 0.56-0.85, P < 0.001) and MEDIUM-volume (OR 0.72, 95% c.i. 0.62-0.83, P < 0.001) centres was lower than in VERY HIGH-volume centres. Of the 4676 rectal cancer patients, the rate of ≥ 12 lymph nodes removed was lower in LOW-volume than in VERY HIGH-volume centres (OR 0.57, 95% c.i. 0.41-0.80, P = 0.001). A lower rate of neoadjuvant chemoradiation was associated with HIGH (OR 0.66, 95% c.i. 0.56-0.77, P < 0.001), MEDIUM (OR 0.75, 95% c.i. 0.60-0.92, P = 0.006), and LOW (OR 0.70, 95% c.i. 0.52-0.94, P = 0.019) volume centres (vs. VERY HIGH). Conclusion: Colorectal cancer surgery in low-volume centres is at higher risk of suboptimal management, poor postoperative outcomes, and less-than-adequate oncologic resections. Centralisation of rectal cancer cases should be taken into consideration to optimise the outcomes.

Published
2024

9. Estandarización de la definición de los tipos de colectomía oncológica. Método Delphi para consenso de expertos de la Asociación Española de Cirujanos

Author

Garcia-Granero, Alvaro, Martín-Martín, Gonzalo P, Dujovne-Lindenbaum, Paula, Alvarez Laso, Carlos J, Cerdán-Santacruz, Carlos, Flor-Lorente, Blas, Biondo, Sebastiano, Die-Trill, J., Pascual Damieta, P., Peña Ros, E., Jimenez Rodríguez, R., Hidalgo Pujol, M., Jiménez Gómez, L.M., Arencibia Pérez, B., Vigorita, V., Colombari, R., Pérez Pérez, T., García Martínez, M.T., Bauxali, J., Cerdán, J., García-Pérez, J.C., Martin-Perez, B., Uribe Quintana, N., Farrés Coll, R., González-Argenté, F.J., Bernal Sprekelsen, J.C., Fraccalvieri, D., Garcia Granero, E., Gómez Ruiz, M., García Cabrera, A.M., Palma, P., Pla-Martí, V., Mera Velasco, S., Blanco-Antona, F., Parajó, A., Salgado, G., Vázquez Monchul, J.M., Ocaña Jiménez, J., Jiménez-Escobar, F., Martí-Gallostra, M., Díaz Pavón, J.M., Salvador-Morales, C., Biondo, S., Espí, A., Solana-Bueno, A., Marín, G., Pastor Idoate, C., Valle-Hernández, E.D., Tejedor, P., Alós Company, R., Elosua, T., Rueda Orgaz, J.A., García Septiem, J., Ballester Ibánez, C., Frasson, M., Hernandis Villalba, J.V., Pascual Miguelañez, I., García-González, J.M., Jimenez-Toscano, M., Benavides Buleje, J.A., Enríquez-Navascués, J.M., Reyes Díaz, M.L., Millan, M., Sánchez-Guillén, L., Roig Vila, J.V., Parra-Baños, P.A., Fernánde, C., Cantero-Cid, R., Truán Alonso, N., Nogués-Ramia, E.M., Serra Pla, S., Climent-Agustín, M., Marinello, F., Moro-Valdezate, D., Frago, R., Espin, E., Pera-Román, M., Álvarez Laso, C.J., Placer-Galan, C., Labalde Martínez, M., García-Armengol, J.J., Codina, A., Capitan-Morales, L.C., Garcia-Aguilar, J., Fernández-Cebrián, J.M., Fernández-Hevia, M., García-Flórez, L.J., Pellino, G., Martínez-Pérez, C., and Fernández-López, F.

Abstract

[Display omitted]

Published
2024
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10. Multistate modelling to estimate excess length of stay and risk of death associated with organ/space infection after elective colorectal surgery

Author

Camprubí, D., Martín, L., Sanz, C., Brugués, M., Serra-Aracil, X., Mora, L., Diaz-Brito, V., Moreno, E., Obradors, F., Espejo, E., Aguilar, F., Pagespetit, L., Nicolás, C., Navarro, A., Vazquez, R., Arroyo, N., López, A.F., Iftimie, S., Shaw, E., Gomila, A., Piriz, M., Perez, R., Cuquet, J., Vazquez, A., Badia, J.M., Lérida, A., Fraccalvieri, D., Marron, A., Freixas, N., Castro, A., Cruz, A., Limón, E., Gudiol, F., Biondo, S., Carratalà, J., and Pujol, M.

Published
2018
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13. Minimum standards of pelvic exenterative practice:PelvEx Collaborative guideline

Author

Fahy, MR, Kelly, ME, Aalbers, AGJ, Abdul Aziz, N, Abecasis, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Albert, M, Andric, M, Angeles, MA, Angenete, E, Antoniou, A, Auer, R, Austin, KK, Aytac, E, Aziz, O, Bacalbasa, N, Baker, RP, Bali, M, Baransi, S, Baseckas, G, Bebington, B, Bedford, M, Bednarski, BK, Beets, GL, Berg, PL, Bergzoll, C, Beynon, J, Biondo, S, Boyle, K, Bordeianou, L, Brecelj, E, Bremers, AB, Brunner, M, Buchwald, P, Bui, A, Burgess, A, Burger, JWA, Burling, D, Burns, E, Campain, N, Carvalhal, S, Castro, L, Caycedo-Marulanda, A, Ceelan, W, Chan, KKL, Chang, GJ, Chang, M, Chew, MH, Chok, AY, Chong, P, Clouston, H, Codd, M, Collins, D, Colquhoun, AJ, Constantinides, J, Corr, A, Coscia, M, Cosimelli, M, Cotsoglou, C, Coyne, PE, Croner, RS, Damjanovich, L, Daniels, IR, Davies, M, Delaney, CP, de Wilt, JHW, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, EJ, Drozdov, E, Duff, M, Eglinton, T, Enriquez-Navascues, JM, Espín-Basany, E, Evans, MD, Eyjólfsdóttir, B, Fearnhead, NS, Ferron, G, Flatmark, K, Fleming, FJ, Flor, B, Folkesson, J, Frizelle, FA, Funder, J, Gallego, MA, Gargiulo, M, García-Granero, E, García-Sabrido, JL, Gava, VG, Gentilini, L, George, ML, George, V, Georgiou, P, Ghosh, A, Ghouti, L, Gil-Moreno, A, Giner, F, Ginther, DN, Glyn, T, Glynn, R, Golda, T, Griffiths, B, Harris, DA, Hagemans, JAW, Hanchanale, V, Harji, DP, Helewa, RM, Hellawell, G, Heriot, AG, Hochman, D, Hohenberger, W, Holm, T, Hompes, R, Hornung, B, Hurton, S, Hyun, E, Ito, M, Iversen, LH, Jenkins, JT, Jourand, K, Kaffenberger, S, Kandaswamy, GV, Kapur, S, Kanemitsu, Y, Kazi, M, Kelley, SR, Keller, DS, Ketelaers, SHJ, Khan, MS, Kiran, RP, Kim, H, Kim, HJ, Koh, CE, Kok, NFM, Kokelaar, R, Kontovounisios, C, Kose, F, Koutra, M, Kristensen, HØ, Kroon, HM, Kumar, S, Kusters, M, Lago, V, Lampe, B, Lakkis, Z, Larach, JT, Larkin, JO, Larsen, SG, Larson, DW, Law, WL, Lee, PJ, Limbert, M, Loria, A, Lydrup, ML, Lyons, A, Lynch, AC, Maciel, J, Manfredelli, S, Mann, C, Mantyh, C, Mathis, KL, Marques, CFS, Martinez, A, Martling, A, Mehigan, BJ, Meijerink, WJHJ, Merchea, A, Merkel, S, Mehta, AM, Mikalauskas, S, McArthur, DR, McCormick, JJ, McCormick, P, McDermott, FD, McGrath, JS, Malde, S, Mirnezami, A, Monson, JRT, Navarro, AS, Negoi, I, Neto, JWM, Ng, JL, Nguyen, B, Nielsen, MB, Nieuwenhuijzen, GAP, Nilsson, PJ, Nordkamp, S, Nugent, T, Oliver, A, O’Dwyer, ST, O’Sullivan, NJ, Paarnio, K, Palmer, G, Pappou, E, Park, J, Patsouras, D, Peacock, O, Pellino, G, Peterson, AC, Pinson, J, Poggioli, G, Proud, D, Quinn, M, Quyn, A, Rajendran, N, Radwan, RW, Rao, C, Rasheed, S, Rausa, E, Regenbogen, SE, Reims, HM, Renehan, A, Rintala, J, Rocha, R, Rochester, M, Rohila, J, Rothbarth, J, Rottoli, M, Roxburgh, C, Rutten, HJT, Safar, B, Sagar, PM, Sahai, A, Saklani, A, Sammour, T, Sayyed, R, Schizas, AMP, Schwarzkopf, E, Scripcariu, D, Scripcariu, V, Selvasekar, C, Shaikh, I, Simpson, A, Skeie-Jensen, T, Smart, NJ, Smart, P, Smith, JJ, Solbakken, AM, Solomon, MJ, Sørensen, MM, Sorrentino, L, Steele, SR, Steffens, D, Stitzenberg, K, Stocchi, L, Stylianides, NA, Swartling, T, Spasojevic, M, Sumrien, H, Sutton, PA, Swartking, T, Takala, H, Tan, EJ, Taylor, C, Tekin, A, Tekkis, PP, Teras, J, Thaysen, HV, Thurairaja, R, Thorgersen, EB, Toh, EL, Tsarkov, P, Tsukada, Y, Tsukamoto, S, Tuech, JJ, Turner, WH, Tuynman, JB, Valente, M, van Ramshorst, GH, van Zoggel, D, Vasquez-Jimenez, W, Vather, R, Verhoef, C, Vierimaa, M, Vizzielli, G, Voogt, ELK, Uehara, K, Urrejola, G, Wakeman, C, Warrier, SK, Wasmuth, HH, Waters, PS, Weber, K, Weiser, MR, Wheeler, JMD, Wild, J, Williams, A, Wilson, M, Wolthuis, A, Yano, H, Yip, B, Yip, J, Yoo, RN, Zappa, MA, Winter, DC, Fahy, Mr, Kelly, Me, Aalbers, Agj, Abdul Aziz, N, Abecasis, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Albert, M, Andric, M, Angeles, Ma, Angenete, E, Antoniou, A, Auer, R, Austin, Kk, Aytac, E, Aziz, O, Bacalbasa, N, Baker, Rp, Bali, M, Baransi, S, Baseckas, G, Bebington, B, Bedford, M, Bednarski, Bk, Beets, Gl, Berg, Pl, Bergzoll, C, Beynon, J, Biondo, S, Boyle, K, Bordeianou, L, Brecelj, E, Bremers, Ab, Brunner, M, Buchwald, P, Bui, A, Burgess, A, Burger, Jwa, Burling, D, Burns, E, Campain, N, Carvalhal, S, Castro, L, Caycedo-Marulanda, A, Ceelan, W, Chan, Kkl, Chang, Gj, Chang, M, Chew, Mh, Chok, Ay, Chong, P, Clouston, H, Codd, M, Collins, D, Colquhoun, Aj, Constantinides, J, Corr, A, Coscia, M, Cosimelli, M, Cotsoglou, C, Coyne, Pe, Croner, R, Damjanovich, L, Daniels, Ir, Davies, M, Delaney, Cp, de Wilt, Jhw, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, Ej, Drozdov, E, Duff, M, Eglinton, T, Enriquez-Navascues, Jm, Espín-Basany, E, Evans, Md, Eyjólfsdóttir, B, Fearnhead, N, Ferron, G, Flatmark, K, Fleming, Fj, Flor, B, Folkesson, J, Frizelle, Fa, Funder, J, Gallego, Ma, Gargiulo, M, García-Granero, E, García-Sabrido, Jl, Gava, Vg, Gentilini, L, George, Ml, George, V, Georgiou, P, Ghosh, A, Ghouti, L, Gil-Moreno, A, Giner, F, Ginther, Dn, Glyn, T, Glynn, R, Golda, T, Griffiths, B, Harris, Da, Hagemans, Jaw, Hanchanale, V, Harji, Dp, Helewa, Rm, Hellawell, G, Heriot, Ag, Hochman, D, Hohenberger, W, Holm, T, Hompes, R, Hornung, B, Hurton, S, Hyun, E, Ito, M, Iversen, Lh, Jenkins, Jt, Jourand, K, Kaffenberger, S, Kandaswamy, Gv, Kapur, S, Kanemitsu, Y, Kazi, M, Kelley, Sr, Keller, D, Ketelaers, Shj, Khan, M, Kiran, Rp, Kim, H, Kim, Hj, Koh, Ce, Kok, Nfm, Kokelaar, R, Kontovounisios, C, Kose, F, Koutra, M, Kristensen, Hø, Kroon, Hm, Kumar, S, Kusters, M, Lago, V, Lampe, B, Lakkis, Z, Larach, Jt, Larkin, Jo, Larsen, Sg, Larson, Dw, Law, Wl, Lee, Pj, Limbert, M, Loria, A, Lydrup, Ml, Lyons, A, Lynch, Ac, Maciel, J, Manfredelli, S, Mann, C, Mantyh, C, Mathis, Kl, Marques, Cf, Martinez, A, Martling, A, Mehigan, Bj, Meijerink, Wjhj, Merchea, A, Merkel, S, Mehta, Am, Mikalauskas, S, Mcarthur, Dr, Mccormick, Jj, Mccormick, P, Mcdermott, Fd, Mcgrath, J, Malde, S, Mirnezami, A, Monson, Jrt, Navarro, A, Negoi, I, Neto, Jwm, Ng, Jl, Nguyen, B, Nielsen, Mb, Nieuwenhuijzen, Gap, Nilsson, Pj, Nordkamp, S, Nugent, T, Oliver, A, O’Dwyer, St, O’Sullivan, Nj, Paarnio, K, Palmer, G, Pappou, E, Park, J, Patsouras, D, Peacock, O, Pellino, G, Peterson, Ac, Pinson, J, Poggioli, G, Proud, D, Quinn, M, Quyn, A, Rajendran, N, Radwan, Rw, Rao, C, Rasheed, S, Rausa, E, Regenbogen, Se, Reims, Hm, Renehan, A, Rintala, J, Rocha, R, Rochester, M, Rohila, J, Rothbarth, J, Rottoli, M, Roxburgh, C, Rutten, Hjt, Safar, B, Sagar, Pm, Sahai, A, Saklani, A, Sammour, T, Sayyed, R, Schizas, Amp, Schwarzkopf, E, Scripcariu, D, Scripcariu, V, Selvasekar, C, Shaikh, I, Simpson, A, Skeie-Jensen, T, Smart, Nj, Smart, P, Smith, Jj, Solbakken, Am, Solomon, Mj, Sørensen, Mm, Sorrentino, L, Steele, Sr, Steffens, D, Stitzenberg, K, Stocchi, L, Stylianides, Na, Swartling, T, Spasojevic, M, Sumrien, H, Sutton, Pa, Swartking, T, Takala, H, Tan, Ej, Taylor, C, Tekin, A, Tekkis, Pp, Teras, J, Thaysen, Hv, Thurairaja, R, Thorgersen, Eb, Toh, El, Tsarkov, P, Tsukada, Y, Tsukamoto, S, Tuech, Jj, Turner, Wh, Tuynman, Jb, Valente, M, van Ramshorst, Gh, van Zoggel, D, Vasquez-Jimenez, W, Vather, R, Verhoef, C, Vierimaa, M, Vizzielli, G, Voogt, Elk, Uehara, K, Urrejola, G, Wakeman, C, Warrier, Sk, Wasmuth, Hh, Waters, P, Weber, K, Weiser, Mr, Wheeler, Jmd, Wild, J, Williams, A, Wilson, M, Wolthuis, A, Yano, H, Yip, B, Yip, J, Yoo, Rn, Zappa, Ma, Winter, Dc, Surgery, CCA - Cancer Treatment and quality of life, CCA - Imaging and biomarkers, and Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Neoplasm Recurrence, Local/surgery, Humans, Surgery, Neoplasm Recurrence, Local, Pelvic Exenteration
Abstract

This document outlines the important aspects of caring for patients who have been diagnosed with advanced pelvic cancer. It is primarily aimed at those who are establishing a service that adequately caters to this patient group. The relevant literature has been summarized and an attempt made to simplify the approach to management of these complex cases.

Published
2022
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14. Simultaneous pelvic exenteration and liver resection for primary rectal cancer with synchronous liver metastases: results from the PelvEx Collaborative

Author

Kelly, M. E., Aalbers, A. G. J., Abdul Aziz, N., Abecasis, N., Abraham‐Nordling, M., Akiyoshi, T., Alberda, W., Albert, M., Andric, M., Angenete, E., Antoniou, A., Auer, R., Austin, K. K., Aziz, O., Baker, R. P., Bali, M., Baseckas, G., Bebington, B., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Boyle, K., Bordeianou, L., Bremers, A. B., Brunner, M., Buchwald, P., Bui, A., Burgess, A., Burger, J. W. A., Burling, D., Burns, E., Campain, N., Carvalhal, S., Castro, L., Caycedo‐Marulanda, A., Chan, K. K. L., Chang, G. J., Chew, M. H., Chong, P. C., Christensen, H. K., Clouston, H., Codd, M., Collins, D., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Croner, R. S., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Delaney, C. P., Denost, Q., Deutsch, C., Dietz, D., Domingo, S., Dozois, E. J., Duff, M., Eglinton, T., Enrique‐Navascues, J. M., Espin‐Basany, E., Evans, M. D., Fearnhead, N. S., Flatmark, K., Fleming, F., Frizelle, F. A., Gallego, M. A., Garcia‐Granero, E., Garcia‐Sabrido, J. L., Gentilini, L., George, M. L., Ghouti, L., Giner, F., Ginther, N., Glynn, R., Golda, T., Griffiths, B., Harris, D. A., Hagemans, J. A. W., Hanchanale, V., Harji, D. P., Helewa, R. M., Heriot, A. G., Hochman, D., Hohenberger, W., Holm, T., Hompes, R., Jenkins, J. T., Kaffenberger, S., Kandaswamy, G. V., Kapur, S., Kanemitsu, Y., Kelley, S. R., Keller, D. S., Khan, M. S., Kiran, R. P., Kim, H., Kim, H. J., Koh, C. E., Kok, N. F. M., Kokelaar, R., Kontovounisios, C., Kristensen, H. Ø., Kroon, H. M., Kusters, M., Lago, V., Larsen, S. G., Larson, D. W., Law, W. L., Laurberg, S., Lee, P. J., Limbert, M., Lydrup, M. L., Lyons, A., Lynch, A. C., Mantyh, C., Mathis, K. L., Margues, C. F. S., Martling, A., Meijerink, W. J. H. J., Merkel, S., Mehta, A. M., McArthur, D. R., McDermott, F. D., McGrath, J. S., Malde, S., Mirnezami, A., Monson, J. R. T., Morton, J. R., Mullaney, T. G., Negoi, I., Neto, J. W. M., Nguyen, B., Nielsen, M. B., Nieuwenhuijzen, G. A. P., Nilsson, P. J., O’Connell, P. R., O’Dwyer, S. T., Palmer, G., Pappou, E., Park, J., Patsouras, D., Pellino, G., Peterson, A. C., Poggioli, G., Proud, D., Quinn, M., Quyn, A., Radwan, R. W., van Ramshorst, G. H., Rasheed, S., Rasmussen, P. C., Regenbogen, S. E., Renehan, A., Rocha, R., Rochester, M., Rohila, J., Rothbarth, J., Rottoli, M., Roxburgh, C., Rutten, H. J. T., Ryan, É. J., Safar, B., Sagar, P. M., Sahai, A., Saklani, A., Sammour, T., Sayyed, R., Schizas, A. M. P., Schwarzkopf, E., Scripcariu, V., Selvasekar, C., Shaikh, I., Hellawell, G., Shida, D., Simpson, A., Smart, N. J., Smart, P., Smith, J. J., Solbakken, A. M., Solomon, M. J., Sørensen, M. M., Steele, S. R., Steffens, D., Stitzenberg, K., Stocchi, L., Stylianides, N. A., Sumrien, H., Sutton, P. A., Swartking, T., Taylor, C., Tekkis, P. P., Teras, J., Thurairaja, R., Toh, E. L., Tsarkov, P., Tsukada, Y., Tsukamoto, S., Tuech, J. J., Turner, W. H., Tuynman, J. B., Vasquez‐Jimenez, W., Verhoef, C., Vizzielli, G., Voogt, E. L. K., Uehara, K., Wakeman, C., Warrier, S., Wasmuth, H. H., Weber, K., Weiser, M. R., Wheeler, J. M. D., Wild, J., Wilson, M., de Wilt, J. H. W., Wolthuis, A., Yano, H., Yip, B., Yip, J., Yoo, R. N., van Zoggel, D., Winter, D. C., Kelly, M. E., Aalbers, A. G. J., Abdul Aziz, N., Abecasis, N., Abraham‐nordling, M., Akiyoshi, T., Alberda, W., Albert, M., Andric, M., Angenete, E., Antoniou, A., Auer, R., Austin, K. K., Aziz, O., Baker, R. P., Bali, M., Baseckas, G., Bebington, B., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Boyle, K., Bordeianou, L., Bremers, A. B., Brunner, M., Buchwald, P., Bui, A., Burgess, A., Burger, J. W. A., Burling, D., Burns, E., Campain, N., Carvalhal, S., Castro, L., Caycedo‐marulanda, A., Chan, K. K. L., Chang, G. J., Chew, M. H., Chong, P. C., Christensen, H. K., Clouston, H., Codd, M., Collins, D., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Croner, R. S., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Delaney, C. P., Denost, Q., Deutsch, C., Dietz, D., Domingo, S., Dozois, E. J., Duff, M., Eglinton, T., Enrique‐navascues, J. M., Espin‐basany, E., Evans, M. D., Fearnhead, N. S., Flatmark, K., Fleming, F., Frizelle, F. A., Gallego, M. A., Garcia‐granero, E., Garcia‐sabrido, J. L., Gentilini, L., George, M. L., Ghouti, L., Giner, F., Ginther, N., Glynn, R., Golda, T., Griffiths, B., Harris, D. A., Hagemans, J. A. W., Hanchanale, V., Harji, D. P., Helewa, R. M., Heriot, A. G., Hochman, D., Hohenberger, W., Holm, T., Hompes, R., Jenkins, J. T., Kaffenberger, S., Kandaswamy, G. V., Kapur, S., Kanemitsu, Y., Kelley, S. R., Keller, D. S., Khan, M. S., Kiran, R. P., Kim, H., Kim, H. J., Koh, C. E., Kok, N. F. M., Kokelaar, R., Kontovounisios, C., Kristensen, H. Ø., Kroon, H. M., Kusters, M., Lago, V., Larsen, S. G., Larson, D. W., Law, W. L., Laurberg, S., Lee, P. J., Limbert, M., Lydrup, M. L., Lyons, A., Lynch, A. C., Mantyh, C., Mathis, K. L., Margues, C. F. S., Martling, A., Meijerink, W. J. H. J., Merkel, S., Mehta, A. M., Mcarthur, D. R., Mcdermott, F. D., Mcgrath, J. S., Malde, S., Mirnezami, A., Monson, J. R. T., Morton, J. R., Mullaney, T. G., Negoi, I., Neto, J. W. M., Nguyen, B., Nielsen, M. B., Nieuwenhuijzen, G. A. P., Nilsson, P. J., O’Connell, P. R., O’Dwyer, S. T., Palmer, G., Pappou, E., Park, J., Patsouras, D., Pellino, G., Peterson, A. C., Poggioli, G., Proud, D., Quinn, M., Quyn, A., Radwan, R. W., van Ramshorst, G. H., Rasheed, S., Rasmussen, P. C., Regenbogen, S. E., Renehan, A., Rocha, R., Rochester, M., Rohila, J., Rothbarth, J., Rottoli, M., Roxburgh, C., Rutten, H. J. T., Ryan, É. J., Safar, B., Sagar, P. M., Sahai, A., Saklani, A., Sammour, T., Sayyed, R., Schizas, A. M. P., Schwarzkopf, E., Scripcariu, V., Selvasekar, C., Shaikh, I., Hellawell, G., Shida, D., Simpson, A., Smart, N. J., Smart, P., Smith, J. J., Solbakken, A. M., Solomon, M. J., Sørensen, M. M., Steele, S. R., Steffens, D., Stitzenberg, K., Stocchi, L., Stylianides, N. A., Sumrien, H., Sutton, P. A., Swartking, T., Taylor, C., Tekkis, P. P., Teras, J., Thurairaja, R., Toh, E. L., Tsarkov, P., Tsukada, Y., Tsukamoto, S., Tuech, J. J., Turner, W. H., Tuynman, J. B., Vasquez‐jimenez, W., Verhoef, C., Vizzielli, G., Voogt, E. L. K., Uehara, K., Wakeman, C., Warrier, S., Wasmuth, H. H., Weber, K., Weiser, M. R., Wheeler, J. M. D., Wild, J., Wilson, M., de Wilt, J. H. W., Wolthuis, A., Yano, H., Yip, B., Yip, J., Yoo, R. N., van Zoggel, D., Winter, D. C., Kelly, ME, Aalbers, AGJ, Aziz, NA, Abecasis, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Albert, M, Andric, M, Angenete, E, Antoniou, A, Auer, R, Austin, KK, Aziz, O, Baker, RP, Bali, M, Baseckas, G, Bebington, B, Bednarski, BK, Beets, GL, Berg, PL, Beynon, J, Biondo, S, Boyle, K, Bordeianou, L, Bremers, AB, Brunner, M, Buchwald, P, Bui, A, Burgess, A, Burger, JWA, Burling, D, Burns, E, Campain, N, Carvalhal, S, Castro, L, Caycedo-Marulanda, A, Chan, KKL, Chew, GJH, Chong, PC, Christensen, HK, Clouston, H, Codd, M, Coffins, D, Colquhoun, AJ, Corr, A, Coscia, M, Coyne, PE, Creavin, B, Croner, RS, Damjanovic, L, Daniels, R, Davies, M, Davies, RJ, Delaney, CP, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, EJ, Duff, M, Eglinton, T, Enrique-Navascues, JM, Espin-Basany, E, Evans, MD, Fearnhead, NS, Flatmark, K, Fleming, F, Frizelle, FA, Gallego, MA, Garcia-Granero, E, Garcia-Sabrido, JL, Gentilini, L, George, ML, Ghouti, L, Giner, F, Ginther, N, Glynn, R, Golda, T, Griffiths, B, Harris, DA, Hagemans, JAW, Hanchanale, V, Harji, DP, Helewa, RM, Heriot, AG, Hochman, D, Hohenberger, W, Holm, T, Hompes, R, Jenkins, JT, Kaffenberger, S, Kandaswamy, GV, Kapur, S, Kanemitsu, Y, Kelley, SR, Keller, DS, Khan, MS, Kiran, RP, Kim, H, Kim, HJ, Koh, CE, Kok, NFM, Kokelaar, R, Kontovounisios, C, Kristensen, HO, Kroon, HM, Kusters, M, Lago, V, Larsen, SG, Larson, DW, Law, WL, Laurberg, S, Lee, PJ, Limbert, M, Lydrup, ML, Lyons, A, Lynch, AC, Mantyh, C, Mathis, KL, Margues, CFS, Martling, A, Meijerink, WJHJ, Merkel, S, Mehta, AM, McArthur, DR, McDermott, FD, McGrath, JS, Malde, S, Mimezami, A, Monson, JRT, Morton, JR, Mullaney, TG, Negoi, I, Neto, JWM, Nguyen, B, Nielsen, MB, Nieuwenhuijzen, GAP, Nilsson, PJ, O'Connell, PR, O'Dwyer, ST, Palmer, G, Pappou, E, Park, J, Patsouras, D, Pellino, G, Peterson, AC, Poggioli, G, Proud, D, Quinn, M, Quyn, A, Radwan, RW, van Ramshorst, GH, Rasheed, S, Rasmussen, PC, Regenbogen, SE, Renehan, A, Rocha, R, Rochester, M, Rohila, J, Rothbarth, J, Rottoli, M, Roxburgh, C, Rutten, HJT, Ryan, EJ, Safar, B, Sagar, PM, Sahai, A, Saklani, A, Sammour, T, Sayyed, R, Schizas, AMP, Schwarzkopf, E, Scripcariu, V, Selvasekar, C, Shaikh, I, Hellawell, G, Shida, D, Simpson, A, Smart, NJ, Smart, P, Smith, JJ, Solbakken, AM, Solomon, MJ, Sorensen, MM, Steele, SR, Steffens, D, Stitzenberg, K, Stocchi, L, Stylianides, NA, Sumrien, H, Sutton, PA, Swanking, T, Taylor, C, Tekkis, PP, Teras, J, Thurairaja, R, Toh, EL, Tsarkov, P, Tsukada, Y, Tsukamoto, S, Tuech, JJ, Turner, WH, Tuynman, JB, Vasquez-Jimenez, W, Verhoef, C, Vizzielli, G, Voogt, ELK, Uehara, K, Wakeman, C, Warner, S, Wasmuth, HH, Weber, K, Weiser, MR, Wheeler, JMD, Wild, J, Wilson, M, de Wilt, JHW, Wolthuis, A, Yano, H, Yip, B, Yip, J, Yoo, RN, van Zoggel, D, Winter, DC, Surgery, CCA - Cancer Treatment and quality of life, and Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Male, medicine.medical_specialty, Adolescent, Colorectal cancer, survival outcomes, medicine.medical_treatment, surgical outcome, surgical outcomes, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Interquartile range, medicine, Humans, liver metastasi, Rectal cancer, Retrospective Studies, Pelvic exenteration, business.industry, Rectal Neoplasms, Mortality rate, Liver Neoplasms, Gastroenterology, Postoperative complication, Perioperative, medicine.disease, Surgery, Pelvic Exenteration, liver metastasis, Treatment Outcome, 030220 oncology & carcinogenesis, international collaboration, Resection margin, 030211 gastroenterology & hepatology, Hepatectomy, Neoplasm Recurrence, Local, business
Abstract

Aim: At presentation, 15–20% of patients with rectal cancer already have synchronous liver metastases. The aim of this study was to determine the surgical and survival outcomes in patients with advanced rectal cancer who underwent combined pelvic exenteration and liver (oligometastatic) resection. Method: Data from 20 international institutions that performed simultaneous pelvic exenteration and liver resection between 2007 and 2017 were accumulated. Primarily, we examined perioperative outcomes, morbidity and mortality. We also assessed the impact that margin status had on survival. Results: Of 128 patients, 72 (56.2%) were men with a median age of 60 years [interquartile range (IQR) 15 years]. The median size of the liver oligometastatic deposits was 2 cm (IQR 1.8 cm). The median duration of surgery was 406 min (IQR 240 min), with a median blood loss of 1090 ml (IQR 2010 ml). A negative resection margin (R0 resection) was achieved in 73.5% of pelvic exenterations and 66.4% of liver resections. The 30-day mortality rate was 1.6%, and 32% of patients had a major postoperative complication. The 5-year overall survival for patients in whom an R0 resection of both primary and metastatic disease was achieved was 54.6% compared with 20% for those with an R1/R2 resection (P = 0.006). Conclusion: Simultaneous pelvic exenteration and liver resection is feasible, with acceptable morbidity and mortality. Simultaneous resection should only be performed where an R0 resection of both pelvic and hepatic disease is anticipated.

Published
2020
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16. Management strategies for patients with advanced rectal cancer and liver metastases using modified Delphi methodology: results from the PelvEx Collaborative

Author

Kelly M. E., Agj A., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K. K., Aziz O., Baker R. P., Bali M., Baseckas G., Bebington B., Bednarski B. K., Beets G. L., Berg P. L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A. B., Brunner M., Buchwald P., Bui A., Burgess A., Jwa B., Burling D., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Kkl C., Chang G. J., Chew M. H., Chong P., Christensen H. K., Clouston H., Codd M., Collins D., Colquhoun A. J., Corr A., Coscia M., Coyne P. E., Creavin B., Croner R. S., Damjanovic L., Daniels I. R., Davies M., Davies R. J., Delaney C. P., de Wilt J., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E. J., Duff M., Eglinton T., Enrique-Navascues J. M., Espin-Basany E., Evans M. D., Fearnhead N. S., Flatmark K., Fleming F., Frizelle F. A., Gallego M. A., Garcia-Granero E., Garcia-Sabrido J. L., Gentilini L., George M. L., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D. A., Jaw H., Hanchanale V., Harji D. P., Helewa R. M., Heriot A. G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J. T., Kaffenberger S., Kandaswamy G. V., Kapur S., Kanemitsu Y., Kelley S. R., Keller D. S., Khan M. S., Kiran R. P., Kim H., Kim H. J., Koh C. E., Nfm K., Kokelaar R., Kontovounisios C., Kristensen H. O., Kroon H. M., Kusters M., Lago V., Larsen S. G., Larson D. W., Law W. L., Laurberg S., Lee P. J., Limbert M., Lydrup M. L., Lyons A., Lynch A. C., Mantyh C., Mathis K. L., Cfs M., Martling A., Wjhj M., Merkel S., Mehta A. M., McArthur D. R., McDermott F. D., McGrath J. S., Malde S., Mirnezami A., Jrt M., Morton J. R., Mullaney T. G., Negoi I., Jwm N., Nguyen B., Nielsen M. B., Gap N., Nilsson P. J., O'Connell P. R., O'Dwyer S. T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A. C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R. W., Rasheed S., Rasmussen P. C., Regenbogen S. E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Hjt R., Ryan E. J., Safar B., Sagar P. M., Sahai A., Saklani A., Sammour T., Sayyed R., Amp S., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shellawell G., Shida D., Simpson A., Smart N. J., Smart P., Smith J. J., Solbakken A. M., Solomon M. J., Sorensen M. M., Steele S. R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N. A., Sumrien H., Sutton P. A., Swartking T., Taylor C., Tekkis P. P., Teras J., Thurairaja R., Toh E. L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J. J., Turner W. H., Tuynman J. B., van Ramshorst G., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Elk V., Uehara K., Wakeman C., Warrier S., Wasmuth H. H., Weber K., Weiser M. R., Jmd W., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R. N., Winter D. C., Rottoli M, Poggioli G, Kelly, M. E., Agj, A., Abdul Aziz, N., Abecasis, N., Abraham-Nordling, M., Akiyoshi, T., Alberda, W., Albert, M., Andric, M., Angenete, E., Antoniou, A., Auer, R., Austin, K. K., Aziz, O., Baker, R. P., Bali, M., Baseckas, G., Bebington, B., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Boyle, K., Bordeianou, L., Bremers, A. B., Brunner, M., Buchwald, P., Bui, A., Burgess, A., Jwa, B., Burling, D., Campain, N., Carvalhal, S., Castro, L., Caycedo-Marulanda, A., Kkl, C., Chang, G. J., Chew, M. H., Chong, P., Christensen, H. K., Clouston, H., Codd, M., Collins, D., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Croner, R. S., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Delaney, C. P., de Wilt, J., Denost, Q., Deutsch, C., Dietz, D., Domingo, S., Dozois, E. J., Duff, M., Eglinton, T., Enrique-Navascues, J. M., Espin-Basany, E., Evans, M. D., Fearnhead, N. S., Flatmark, K., Fleming, F., Frizelle, F. A., Gallego, M. A., Garcia-Granero, E., Garcia-Sabrido, J. L., Gentilini, L., George, M. L., Ghouti, L., Giner, F., Ginther, N., Glynn, R., Golda, T., Griffiths, B., Harris, D. A., Jaw, H., Hanchanale, V., Harji, D. P., Helewa, R. M., Heriot, A. G., Hochman, D., Hohenberger, W., Holm, T., Hompes, R., Jenkins, J. T., Kaffenberger, S., Kandaswamy, G. V., Kapur, S., Kanemitsu, Y., Kelley, S. R., Keller, D. S., Khan, M. S., Kiran, R. P., Kim, H., Kim, H. J., Koh, C. E., Nfm, K., Kokelaar, R., Kontovounisios, C., Kristensen, H. O., Kroon, H. M., Kusters, M., Lago, V., Larsen, S. G., Larson, D. W., Law, W. L., Laurberg, S., Lee, P. J., Limbert, M., Lydrup, M. L., Lyons, A., Lynch, A. C., Mantyh, C., Mathis, K. L., Cfs, M., Martling, A., Wjhj, M., Merkel, S., Mehta, A. M., Mcarthur, D. R., Mcdermott, F. D., Mcgrath, J. S., Malde, S., Mirnezami, A., Jrt, M., Morton, J. R., Mullaney, T. G., Negoi, I., Jwm, N., Nguyen, B., Nielsen, M. B., Gap, N., Nilsson, P. J., O'Connell, P. R., O'Dwyer, S. T., Palmer, G., Pappou, E., Park, J., Patsouras, D., Pellino, G., Peterson, A. C., Poggioli, G., Proud, D., Quinn, M., Quyn, A., Radwan, R. W., Rasheed, S., Rasmussen, P. C., Regenbogen, S. E., Renehan, A., Rocha, R., Rochester, M., Rohila, J., Rothbarth, J., Rottoli, M., Roxburgh, C., Hjt, R., Ryan, E. J., Safar, B., Sagar, P. M., Sahai, A., Saklani, A., Sammour, T., Sayyed, R., Amp, S., Schwarzkopf, E., Scripcariu, V., Selvasekar, C., Shaikh, I., Shellawell, G., Shida, D., Simpson, A., Smart, N. J., Smart, P., Smith, J. J., Solbakken, A. M., Solomon, M. J., Sorensen, M. M., Steele, S. R., Steffens, D., Stitzenberg, K., Stocchi, L., Stylianides, N. A., Sumrien, H., Sutton, P. A., Swartking, T., Taylor, C., Tekkis, P. P., Teras, J., Thurairaja, R., Toh, E. L., Tsarkov, P., Tsukada, Y., Tsukamoto, S., Tuech, J. J., Turner, W. H., Tuynman, J. B., van Ramshorst, G., van Zoggel, D., Vasquez-Jimenez, W., Verhoef, C., Vizzielli, G., Elk, V., Uehara, K., Wakeman, C., Warrier, S., Wasmuth, H. H., Weber, K., Weiser, M. R., Jmd, W., Wild, J., Wilson, M., Wolthuis, A., Yano, H., Yip, B., Yip, J., Yoo, R. N., Winter, D. C., and Academic Medical Center

Subjects
Liver metastasisSurvival Outcome, medicine.medical_specialty, survival outcomes, Colorectal cancer, surgical outcome, medicine.medical_treatment, Delphi method, Rectum, Disease, surgical outcomes, 03 medical and health sciences, Liver disease, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Hepatectomy, Humans, Medicine, liver metastasi, Rectal cancer, Neoplasm Staging, Pelvic exenteration, Rectal Neoplasms, business.industry, General surgery, Liver Neoplasms, Gastroenterology, Induction chemotherapy, medicine.disease, liver metastasis, medicine.anatomical_structure, 030220 oncology & carcinogenesis, international collaboration, 030211 gastroenterology & hepatology, business
Abstract

Aim: A total of 15–20% of patients with rectal cancer have liver metastases on presentation. The management of these patients is controversial. Heterogeneity in management strategies is considerable, with management often being dependent on local resources and available expertise. Method: Members of the PelvEx Collaborative were invited to participate in the generation of a consensus statement on the optimal management of patients with advanced rectal cancer with liver involvement. Fifteen statements were created for topical discussion on diagnostic and management issues. Panellists were asked to vote on statements and anonymous feedback was given. A collaborative meeting was used to discuss any nuances and clarify any obscurity. Consensus was considered when > 85% agreement on a statement was achieved. Results: A total of 135 participants were involved in the final round of the Delphi questionnaire. Nine of the 15 statements reached consensus regarding the management of patients with advanced rectal cancer and oligometastatic liver disease. Routine use of liver MRI was not recommended for patients with locally advanced rectal cancer, unless there was concern for metastatic disease on initial computed tomography staging scan. Induction chemotherapy was advocated as first-line treatment in those with synchronous liver metastases in locally advanced rectal cancer. In the presence of symptomatic primary disease, a diverting stoma may be required to facilitate induction chemotherapy. Overall, only one-quarter of the panellists would consider simultaneous pelvic exenteration and liver resection. Conclusion: This Delphi process highlights the diverse treatment of advanced rectal cancer with liver metastases and provides recommendations from an experienced international group regarding the multidisciplinary management approach.

Published
2020
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19. Contemporary management of locally advanced and recurrent rectal cancer: views from the PelvEx collaborative

Author

Kelly M. E., O’Sullivan N. J., Fahy M. R., Aalbers A. G. J., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Abu Saadeh F., Akiyoshi T., Alberda W., Albert M., Andric M., Angeles M. A., Angenete E., Antoniou A., Auer R., Austin K. K., Aytac E., Aziz O., Bacalbasa N., Baker R. P., Bali M., Baransi S., Baseckas G., Bebington B., Bedford M., Bednarski B. K., Beets G. L., Berg P. L., Bergzoll C., Beynon J., Biondo S., Boyle K., Bordeianou L., Brecelj E., Bremers A. B., Brunner M., Buchwald P., Bui A., Burgess A., Burger J. W. A., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Ceelen W., Chan K. K. L., Chang G. J., Chang M., Chew M. H., Chok A. Y., Chong P., Clouston H., Codd M., Collins D., Colquhoun A. J., Constantinides J., Corr A., Coscia M., Cosimelli M., Cotsoglou C., Coyne P. E., Croner R. S., Damjanovich L., Daniels I. R., Davies M., Delaney C. P., de Wilt J. H. W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E. J., Drozdov E., Duff M., Eglinton T., Enriquez-Navascues J. M., Espín-Basany E., Evans M. D., Eyjólfsdóttir B., Fearnhead N. S., Ferron G., Fichtner-Feigl S., Flatmark K., Fleming F. J., Flor B., Folkesson J., Frizelle F. A., Funder J., Gallego M. A., Gargiulo M., García-Granero E., García-Sabrido J. L., Gava V. G., Gentilini L., George M. L., George V., Georgiou P., Ghosh A., Ghouti L., Gil-Moreno A., Giner F., Ginther D. N., Glyn T., Glynn R., Golda T., Griffiths B., Harris D. A., Hanchanale V., Harji D. P., Harris C., Helewa R. M., Hellawell G., Heriot A. G., Hochman D., HohenbergerW., Holm T., Hompes R., Hornung B., Hurton S., Hyun E., Ito M., Iversen L. H., Jenkins J. T., Jourand K., Kaffenberger S., Kandaswamy G. V., Kapur S., Kanemitsu Y., Kazi M., Kelley S. R., Keller D. S., Ketelaers S. H. J., Khan M. S., Kiran R. P., Kim H., Kim H. J., Koh C. E., Kok N. F. M., Kokelaar R., Kontovounisios C., Kose F., Koutra M., Kristensen H. Ø., Kroon H. M., Kumar S., Kusters M., Lago V., Lampe B., Lakkis Z., Larach J. T., Larkin J. O., Larsen S. G., Larson D. W., Law W. L., Lee P. J., Limbert M., Loria A., Lydrup ML., Lyons A., Lynch A. C., Maciel J., Manfredelli S., Mann C., Mantyh C., Mathis K. L., Marques C. F. S., Martinez A., Martling A., Mehigan B. J., MeijerinkW. J. H. J., Merchea A., Merkel S., Mehta A. M., Mikalauskas S., McArthur D. R., McCormick J. J., McCormick P., McDermott F. D., McGrath J. S., Malde S., Mirnezami A., Monson J. R. T., Navarro A. S., Neeff H., Negoi I., Neto J. W. M., Ng J. L., Nguyen B., Nielsen M. B., Nieuwenhuijzen G. A. P., Nilsson P. J., Nordkamp S., Nugent T., Oliver A., O’Dwyer S. T., Paarnio K., Palmer G., Pappou E., Park J., Patsouras D., Peacock O., Pellino G., Peterson A. C., Pfeffer F., Pinson J., Poggioli G., Proud D., Quinn M., Quyn A., Rajendran N., Radwan R. W., Rao C., Rasheed S., Rausa E., Regenbogen S. E., Reims H. M., Renehan A., Rintala J., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Rutten H. J. T., Safar B., Sagar P. M., Sahai A., Saklani A., Sammour T., Sayyed R., Schizas A. M. P., Schwarzkopf E., Scripcariu D., Scripcariu V., Selvasekar C., Shaikh I., Simpson A., Skeie-Jensen T., Smart N. J., Smart P., Smith J. J., Solbakken A. M., Solomon M. J., Sørensen M. M., Sorrentino L., Steele S. R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N. A., Swartling T., Spasojevic M., Sumrien H., Sutton P. A., Swartking T., Takala H., Tan E. J., Taylor C., Taylor D., Tekin A., Tekkis P. P., Teras J., Thaysen H. V., Thurairaja R., Thorgersen E. B., Tiernan J., Toh E. L., Tolenaar J., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J. J., Turner W. H., Tuynman J. B., Valente M., van Ramshorst G. H., van Rees J., van Zoggel D., Vasquez-JimenezW., Vather R., Verhoef C., Vierimaa M., Vizzielli G., Voogt E. L. K., Uehara K., Urrejola G., Wakeman C., Warrier S. K., Wasmuth H. H., Waters P. S., Weber K., Weiser M. R., Wheeler J. M. D., Wild J., Williams A., Wilson M., Wolthuis A., Yano H., Yip B., Yoo R. N., Zappa M. A., Winter D. C., and Kelly M.E., O’Sullivan N.J., Fahy M.R., Aalbers A.G.J., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Abu Saadeh F., Akiyoshi T., Alberda W., Albert M., Andric M., Angeles M.A., Angenete E., Antoniou A., Auer R., Austin K.K., Aytac E., Aziz O., Bacalbasa N., Baker R.P., Bali M., Baransi S., Baseckas G., Bebington B., Bedford M., Bednarski B.K., Beets G.L., Berg P.L., Bergzoll C., Beynon J., Biondo S., Boyle K., Bordeianou L., Brecelj E., Bremers A.B., Brunner M., Buchwald P., Bui A., Burgess A., Burger J.W.A., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Ceelen W., Chan K.K.L., Chang G.J., Chang M., Chew M.H., Chok A.Y., Chong P., Clouston H., Codd M., Collins D., Colquhoun A.J., Constantinides J., Corr A., Coscia M., Cosimelli M., Cotsoglou C., Coyne P.E., Croner R.S., Damjanovich L., Daniels I.R., Davies M., Delaney C.P., de Wilt J.H.W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E.J., Drozdov E., Duff M., Eglinton T., Enriquez-Navascues J.M., Espín-Basany E., Evans M.D., Eyjólfsdóttir B., Fearnhead N.S., Ferron G., Fichtner-Feigl S., Flatmark K., Fleming F.J., Flor B., Folkesson J., Frizelle F.A., Funder J., Gallego M.A., Gargiulo M., García-Granero E., García-Sabrido J.L., Gargiulo M., Gava V.G., Gentilini L., George M.L., George V., Georgiou P., Ghosh A., Ghouti L., Gil-Moreno A., Giner F., Ginther D.N., Glyn T., Glynn R., Golda T., Griffiths B., Harris D.A., Hanchanale V., Harji D.P., Harris C., Helewa R.M., Hellawell G., Heriot A.G., Hochman D., HohenbergerW., Holm T., Hompes R., Hornung B., Hurton S., Hyun E., Ito M., Iversen L.H., Jenkins J.T., Jourand K., Kaffenberger S., Kandaswamy G.V., Kapur S., Kanemitsu Y., Kazi M., Kelley S.R., Keller D.S., Ketelaers S.H.J., Khan M.S., Kiran R.P., Kim H., Kim H.J., Koh C.E., Kok N.F.M., Kokelaar R., Kontovounisios C., Kose F., Koutra M., Kristensen H.Ø., Kroon H.M., Kumar S., Kusters M., Lago V., Lampe B., Lakkis Z., Larach J.T., Larkin J.O., Larsen S.G., Larson D.W., Law W.L., Lee P.J., Limbert M., Loria A., Lydrup ML., Lyons A., Lynch A.C., Maciel J., Manfredelli S., Mann C., Mantyh C., Mathis K.L., Marques C.F.S., Martinez A., Martling A., Mehigan B.J., MeijerinkW.J.H.J., Merchea A., Merkel S., Mehta A.M., Mikalauskas S., McArthur D.R., McCormick J.J., McCormick P., McDermott F.D., McGrath J.S., Malde S., Mirnezami A., Monson J.R.T., Navarro A.S., Neeff H., Negoi I., Neto J.W.M., Ng J.L., Nguyen B., Nielsen M.B., Nieuwenhuijzen G.A.P., Nilsson P.J., Nordkamp S., Nugent T., Oliver A., O’Dwyer S.T., Paarnio K., Palmer G., Pappou E., Park J., Patsouras D., Peacock O., Pellino G., Peterson A.C., Pfeffer F., Pinson J., Poggioli G., Proud D., Quinn M., Quyn A., Rajendran N., Radwan R.W., Rajendran N., Rao C., Rasheed S., Rausa E., Regenbogen S.E., Reims H.M., Renehan A., Rintala J., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Rutten H.J.T., Safar B., Sagar P.M., Sahai A., Saklani A., Sammour T., Sayyed R., Schizas A.M.P., Schwarzkopf E., Scripcariu D., Scripcariu V., Selvasekar C., Shaikh I., Simpson A., Skeie-Jensen T., Smart N.J., Smart P., Smith J.J., Solbakken A.M., Solomon M.J., Sørensen M.M., Sorrentino L., Steele S.R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N.A., Swartling T., Spasojevic M., Sumrien H., Sutton P.A., Swartking T., Takala H., Tan E.J., Taylor C., Taylor D., Tekin A., Tekkis P.P., Teras J., Thaysen H.V., Thurairaja R., Thorgersen E.B., Tiernan J., Toh E.L., Tolenaar J., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J.J., Turner W.H., Tuynman J.B., Valente M., van Ramshorst G.H., van Rees J., van Zoggel D., Vasquez-JimenezW., Vather R., Verhoef C., Vierimaa M., Vizzielli G., Voogt E.L.K., Uehara K., Urrejola G., Wakeman C., Warrier S.K.,Wasmuth H.H.,Waters P.S.,Weber K.,Weiser M.R., Wheeler J.M.D.,Wild J., Williams A., Wilson M., Wolthuis A., Yano H., Yip B., Yoo R.N., Zappa M.A., Winter D.C.

Subjects
Cancer Research, perioperative care, ENHANCED RECOVERY, diagnostic, EXENTERATION, surgical management, surgical outcomes, recurrent rectal cancer, SDG 3 - Good Health and Well-being, locally advanced rectal cancer, QUALITY-OF-LIFE, Medicine and Health Sciences, diagnostics, 1112 Oncology and Carcinogenesis, PATHOLOGICAL COMPLETE RESPONSE, rectal cancer, SURGICAL TECHNIQUES, OUTCOMES, Science & Technology, HYPERTHERMIC INTRAPERITONEAL, PelvEx Collaborative, CHEMOTHERAPY, WHOLE-BODY MRI, NEOADJUVANT CHEMORADIOTHERAPY, Oncology, quality of life, CYTOREDUCTIVE SURGERY, HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY, Life Sciences & Biomedicine
Abstract

Pelvic exenteration is a complex operation performed for locally advanced and recurrent pelvic cancers. The goal of surgery is to achieve clear margins, therefore identifying adjacent or involved organs, bone, muscle, nerves and/or vascular structures that may need resection. While these extensive resections are potentially curative, they can be associated with substantial morbidity. Recently, there has been a move to centralize care to specialized units, as this facilitates better multidisciplinary care input. Advancements in pelvic oncology and surgical innovation have redefined the boundaries of pelvic exenterative surgery. Combined with improved neoadjuvant therapies, advances in diagnostics, and better reconstructive techniques have provided quicker recovery and better quality of life outcomes, with improved survival This article provides highlights of the current management of advanced pelvic cancers in terms of surgical strategy and potential future developments.

Published
2022
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20. Defining Major Surgery: A Delphi Consensus Among European Surgical Association (ESA) Members

Author

Martin, D., Mantziari, S., Demartines, N., Hubner, M., Bismuth, H., Sarr, M. G., Strasberg, S. M., Wexner, S. D., Adham, M., Altomare, D. F., Andersson, R., Bechstein, W., Biondo, S., Bockhorn, M., Bonavina, L., Rituerto, D. C., Clavien, P. -A., De Manzini, N., Decker, G., Dejong, C. H., Dervenis, C., Farges, O., Figueras, J., Fingerhut, A. L., Friess, H., Glehen, O., Gnant, M., Gutschow, C., Hahnloser, D., Hamberger, B., Hamming, J. F., Holscher, A. H., Izbicki, J. R., Jonas, S., Karamarkovic, A., Kehlet, H., Leppaniemi, A. K., Lerut, J., Line, P. -D., Lodge, J. P. A., Meakins, J. L., Montorsi, M., Nafteux, P., Naredi, P., Olah, A., Panis, Y., Pardo, F., Parks, R. W., Pedrazzoli, S., Pessaux, P., Marques, H. P., Poggioli, G., Popescu, I., Puolakkainen, P. A., Ramia Angel, J. M., Rasanen, J., Reynolds, J. V., Rosati, R., Saeger, H. -D., Schneeberger, S., Schneider, P. M., Soreide, K., Stippel, D., Toso, C., Tuech, J. -J., Tukiainen, E. J., Van Hillegersberg, R., Wijnhoven, B., Winter, D. C., Zaninotto, G., Surgery, Martin, D., Mantziari, S., Demartines, N., Hubner, M., Bismuth, H., Sarr, M. G., Strasberg, S. M., Wexner, S. D., Adham, M., Altomare, D. F., Andersson, R., Bechstein, W., Biondo, S., Bockhorn, M., Bonavina, L., Rituerto, D. C., Clavien, P. -A., De Manzini, N., Decker, G., Dejong, C. H., Dervenis, C., Farges, O., Figueras, J., Fingerhut, A. L., Friess, H., Glehen, O., Gnant, M., Gutschow, C., Hahnloser, D., Hamberger, B., Hamming, J. F., Holscher, A. H., Izbicki, J. R., Jonas, S., Karamarkovic, A., Kehlet, H., Leppaniemi, A. K., Lerut, J., Line, P. -D., Lodge, J. P. A., Meakins, J. L., Montorsi, M., Nafteux, P., Naredi, P., Olah, A., Panis, Y., Pardo, F., Parks, R. W., Pedrazzoli, S., Pessaux, P., Marques, H. P., Poggioli, G., Popescu, I., Puolakkainen, P. A., Ramia Angel, J. M., Rasanen, J., Reynolds, J. V., Rosati, R., Saeger, H. -D., Schneeberger, S., Schneider, P. M., Soreide, K., Stippel, D., Toso, C., Tuech, J. -J., Tukiainen, E. J., Van Hillegersberg, R., Wijnhoven, B., Winter, D. C., Zaninotto, G., Martin D., Mantziari S., Demartines N., Hubner M., Bismuth H., Sarr M.G., Strasberg S.M., Wexner S.D., Adham M., Altomare D.F., Andersson R., Bechstein W., Biondo S., Bockhorn M., Bonavina L., Rituerto D.C., Clavien P.-A., De Manzini N., Decker G., Dejong C.H., Dervenis C., Farges O., Figueras J., Fingerhut A.L., Friess H., Glehen O., Gnant M., Gutschow C., Hahnloser D., Hamberger B., Hamming J.F., Holscher A.H., Izbicki J.R., Jonas S., Karamarkovic A., Kehlet H., Leppaniemi A.K., Lerut J., Line P.-D., Lodge J.P.A., Meakins J.L., Montorsi M., Nafteux P., Naredi P., Olah A., Panis Y., Pardo F., Parks R.W., Pedrazzoli S., Pessaux P., Marques H.P., Poggioli G., Popescu I., Puolakkainen P.A., Ramia Angel J.M., Rasanen J., Reynolds J.V., Rosati R., Saeger H.-D., Schneeberger S., Schneider P.M., Soreide K., Stippel D., Toso C., Tuech J.-J., Tukiainen E.J., Van Hillegersberg R., Wijnhoven B., Winter D.C., Zaninotto G., ESA Study Group, Sarr, M.G., Strasberg, S.M., Wexner, S.D., Altomare, D.F., Rituerto, D.C., Clavien, P.A., Dejong, C.H., Fingerhut, A.L., Hamming, J.F., Hölscher, A.H., Izbicki, J.R., Leppäniemi, A.K., Line, P.D., Lodge, JPA, Meakins, J.L., Oláh, A., Parks, R.W., Marques, H.P., Puolakkainen, P.A., Ramia Angel, J.M., Reynolds, J.V., Saeger, H.D., Schneider, P.M., Søreide, K., Tuech, J.J., Tukiainen, E.J., Winter, D.C., Institut de Recherche sur les Maladies Virales et Hépatiques (IVH), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Zurich, Demartines, Nicolas, and Toso, Christian

Subjects
Male, medicine.medical_specialty, Blood transfusion, Consensus, Delphi Technique, medicine.medical_treatment, Delphi method, 610 Medicine & health, Consensu, Likert scale, 03 medical and health sciences, Surgeon, 0302 clinical medicine, Aged, Europe, Humans, Middle Aged, Societies, Medical, Surgeons, Surgical Procedures, Operative/methods, Medical, major surgery, Delphi consensus definition, medicine, Operative / methods, 10217 Clinic for Visceral and Transplantation Surgery, Surgical Procedures, ddc:617, business.industry, Perioperative, Vascular surgery, 2746 Surgery, 3. Good health, Cardiac surgery, Surgery, Cardiothoracic surgery, 030220 oncology & carcinogenesis, Surgical Procedures, Operative, 030211 gastroenterology & hepatology, Societies, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Abdominal surgery, Human
Abstract

Background: Major surgery is a term frequently used but poorly defined. The aim of the present study was to reach a consensus in the definition of major surgery within a panel of expert surgeons from the European Surgical Association (ESA). Methods: A 3-round Delphi process was performed. All ESA members were invited to participate in the expert panel. In round 1, experts were inquired by open- and closed-ended questions on potential criteria to define major surgery. Results were analyzed and presented back anonymously to the panel within next rounds. Closed-ended questions in round 2 and 3 were either binary or statements to be rated on a Likert scale ranging from 1 (strong disagreement) to 5 (strong agreement). Participants were sent 3 reminders at 2-week intervals for each round. 70% of agreement was considered to indicate consensus. Results: Out of 305 ESA members, 67 (22%) answered all the 3 rounds. Significant comorbidities were the only preoperative factor retained to define major surgery (78%). Vascular clampage or organ ischemia (92%), high intraoperative blood loss (90%), high noradrenalin requirements (77%), long operative time (73%) and perioperative blood transfusion (70%) were procedure-related factors that reached consensus. Regarding postoperative factors, systemic inflammatory response (76%) and the need for intensive or intermediate care (88%) reached consensus. Consequences of major surgery were high morbidity (>30% overall) and mortality (>2%). Conclusion: ESA experts defined major surgery according to extent and complexity of the procedure, its pathophysiological consequences and consecutive clinical outcomes.

Published
2020
Full Text
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22. Upfront surgery versus self-expanding metallic stent as bridge to surgery in left-sided colonic cancer obstruction: A multicenter observational study

Author

Hidalgo-Pujol M, Biondo S, Trill J, Vigorita V, Garcia-Senorans M, Miguelanez I, Noire F, Timoteo A, Cornejo L, Parra J, Garcia M, Solis-Pena A, de Tudela A, Gonzalez A, Sanchez-Guillen L, Recuenco C, Perez-Alonso C, Caballero E, Pascual M, Septiem J, Lopez L, Cervera-Aldama J, Gudalajara H, Espin E, and Kreisler E

Subjects
COMPLICATIONS, RESECTION, CONVENTIONAL OPEN SURGERY, LAPAROSCOPIC APPROACH, MANAGEMENT, SURVIVAL, LARGE-BOWEL OBSTRUCTION, CLINICAL-PRACTICE GUIDELINES, EMERGENCY-SURGERY, ONCOLOGIC OUTCOMES
Abstract

Background: Oncological outcomes of self-expanding metallic stent used as a bridge to surgery in potential curative patients with left-sided colonic cancer obstruction remain unclear. The aim of this study was to investigate perioperative and mid-term oncological outcomes of 2 of the currently most commonly performed treatments in left-sided colonic cancer obstruction.Methods: This is a retrospective multicenter study including patients with left-sided colonic cancer obstruction treated with curative intent between 2013 and 2017. The presence of metastasis at diagnosis was an exclusion criterion. The primary outcome was to evaluate the noninferiority, in terms of overall survival, of bridge to surgery strategy compared with emergency colonic resection. The secondary outcomes were perioperative morbimortality, disease free survival, local recurrence, and distant recurrence.Results: A total of 564 patients were included, 320 in the emergency colonic resection group and 244 in the bridge to surgery group. Twenty-seven patients of the bridge-to-surgery group needed urgent operation. Postoperative morbidity rates were statistically higher in the emergency colonic resection group (odds ratio [95% confidence interval] 0.37 [0.24-0.55], P < .001). There was no difference in 90-day mortality between groups (odds ratio [95% confidence interval] 0.85 [0.36-1.99], P = .702). The median follow-up was 3.80 years (2.29-4.92). The results show the noninferiority of bridge to surgery versus emergency colonic resection in terms of overall survival (hazard ratio [95% confidence interval) 0.78 [0.56-1.07], P = .127). There were no differences in disease free survival, distant recurrence, and local recurrence rates between bridge to surgery and emergency colonic resection groups.Conclusion: Self-expanding metallic stent as bridge to surgery might not lead to a negative impact on the long-term prognosis of the tumor compared with emergency colonic resection in expert hands and selected patients. (c) 2022 Elsevier Inc. All rights reserved.

Published
2022

24. The impact of the COVID-19 pandemic on the Management of Locally Advanced Primary/Recurrent Rectal Cancer

Author

Chok A. Y., Kontovounisios C., Rasheed S., Kelly M. E., Agj A., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K. K., Aziz O., Baker R. P., Bali M., Baseckas G., Bebington B., Bedford M., Bednarski B. K., Beets G. L., Berg P. L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A. B., Brunner M., Buchwald P., Bui A., Burgess A., Jwa B., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Kkl C., Chang G. J., Chang M., Chew M. H., Chong P., Christensen H. K., Clouston H., Codd M., Collins D., Colquhoun A. J., Corr A., Coscia M., Cosimelli M., Coyne P. E., Creavin B., Croner R. S., Damjanovic L., Daniels I. R., Davies M., Davies R. J., Delaney C. P., Jhw D. W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E. J., Duff M., Eglinton T., Enrique-Navascues J. M., Espin-Basany E., Evans M. D., Fearnhead N. S., Flatmark K., Fleming F., Frizelle F. A., Gallego M. A., Garcia-Granero E., Garcia-Sabrido J. L., Gentilini L., George M. L., George V., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D. A., Jaw H., Hanchanale V., Harji D. P., Helewa R. M., Hellawell G., Heriot A. G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J. T., Kaffenberger S., Kandaswamy G. V., Kapur S., Kanemitsu Y., Kelley S. R., Keller D. S., Khan M. S., Kim H., Kim H. J., Koh C. E., Nfm K., Kokelaar R., Kristensen H. O., Kroon H. M., Kusters M., Lago V., Larsen S. G., Larson D. W., Law W. L., Laurberg S., Lee P. J., Limbert M., Lydrup M. L., Lyons A., Lynch A. C., Mantyh C., Mathis K. L., Cfs M., Martling A., Wjhj M., Merkel S., Mehta A. M., McArthur D. R., McDermott F. D., McGrath J. S., Malde S., Mirnezami A., Jrt M., Morton J. R., Mullaney T. G., Negoi I., Jwm N., Ng J. L., Nguyen B., Nielsen M. B., Gap N., Nilsson P. J., Oliver A., O'Dwyer S. T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A. C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R. W., Rasmussen P. C., Rausa E., Regenbogen S. E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Hjt R., Ryan E. J., Safar B., Sagar P. M., Sahai A., Saklani A., Sammour T., Sayyed R., Amp S., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shida D., Simpson A., Smart N. J., Smart P., Smith J. J., Solbakken A. M., Solomon M. J., Sorensen M. M., Steele S. R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N. A., Swartling T., Sumrien H., Sutton P. A., Swartking T., Tan E. J., Taylor C., Teras J., Thurairaja R., Toh E. L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J. J., Turner W. H., Tuynman J. B., van Ramshorst G. H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Elk V., Uehara K., Wakeman C., Warrier S., Wasmuth H. H., Weber K., Weiser M. R., Jmd W., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R. N., Zappa M. A., Winter D. C., Tekkis P. P., Chok A.Y., Kontovounisios C., Rasheed S., Kelly M.E., Agj A., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K.K., Aziz O., Baker R.P., Bali M., Baseckas G., Bebington B., Bedford M., Bednarski B.K., Beets G.L., Berg P.L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A.B., Brunner M., Buchwald P., Bui A., Burgess A., Jwa B., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Kkl C., Chang G.J., Chang M., Chew M.H., Chong P., Christensen H.K., Clouston H., Codd M., Collins D., Colquhoun A.J., Corr A., Coscia M., Cosimelli M., Coyne P.E., Creavin B., Croner R.S., Damjanovic L., Daniels I.R., Davies M., Davies R.J., Delaney C.P., Jhw D.W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E.J., Duff M., Eglinton T., Enrique-Navascues J.M., Espin-Basany E., Evans M.D., Fearnhead N.S., Flatmark K., Fleming F., Frizelle F.A., Gallego M.A., Garcia-Granero E., Garcia-Sabrido J.L., Gentilini L., George M.L., George V., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D.A., Jaw H., Hanchanale V., Harji D.P., Helewa R.M., Hellawell G., Heriot A.G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J.T., Kaffenberger S., Kandaswamy G.V., Kapur S., Kanemitsu Y., Kelley S.R., Keller D.S., Khan M.S., Kim H., Kim H.J., Koh C.E., Nfm K., Kokelaar R., Kristensen H.O., Kroon H.M., Kusters M., Lago V., Larsen S.G., Larson D.W., Law W.L., Laurberg S., Lee P.J., Limbert M., Lydrup M.L., Lyons A., Lynch A.C., Mantyh C., Mathis K.L., Cfs M., Martling A., Wjhj M., Merkel S., Mehta A.M., McArthur D.R., McDermott F.D., McGrath J.S., Malde S., Mirnezami A., Jrt M., Morton J.R., Mullaney T.G., Negoi I., Jwm N., Ng J.L., Nguyen B., Nielsen M.B., Gap N., Nilsson P.J., Oliver A., O'Dwyer S.T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A.C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R.W., Rasmussen P.C., Rausa E., Regenbogen S.E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Hjt R., Ryan E.J., Safar B., Sagar P.M., Sahai A., Saklani A., Sammour T., Sayyed R., Amp S., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shida D., Simpson A., Smart N.J., Smart P., Smith J.J., Solbakken A.M., Solomon M.J., Sorensen M.M., Steele S.R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N.A., Swartling T., Sumrien H., Sutton P.A., Swartking T., Tan E.J., Taylor C., Teras J., Thurairaja R., Toh E.L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J.J., Turner W.H., Tuynman J.B., van Ramshorst G.H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Elk V., Uehara K., Wakeman C., Warrier S., Wasmuth H.H., Weber K., Weiser M.R., Jmd W., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R.N., Zappa M.A., Winter D.C., Tekkis P.P., Chok, A. Y., Kontovounisios, C., Rasheed, S., Kelly, M. E., Agj, A., Abdul Aziz, N., Abecasis, N., Abraham-Nordling, M., Akiyoshi, T., Alberda, W., Albert, M., Andric, M., Angenete, E., Antoniou, A., Auer, R., Austin, K. K., Aziz, O., Baker, R. P., Bali, M., Baseckas, G., Bebington, B., Bedford, M., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Boyle, K., Bordeianou, L., Bremers, A. B., Brunner, M., Buchwald, P., Bui, A., Burgess, A., Jwa, B., Burling, D., Burns, E., Campain, N., Carvalhal, S., Castro, L., Caycedo-Marulanda, A., Kkl, C., Chang, G. J., Chang, M., Chew, M. H., Chong, P., Christensen, H. K., Clouston, H., Codd, M., Collins, D., Colquhoun, A. J., Corr, A., Coscia, M., Cosimelli, M., Coyne, P. E., Creavin, B., Croner, R. S., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Delaney, C. P., Jhw, D. W., Denost, Q., Deutsch, C., Dietz, D., Domingo, S., Dozois, E. J., Duff, M., Eglinton, T., Enrique-Navascues, J. M., Espin-Basany, E., Evans, M. D., Fearnhead, N. S., Flatmark, K., Fleming, F., Frizelle, F. A., Gallego, M. A., Garcia-Granero, E., Garcia-Sabrido, J. L., Gentilini, L., George, M. L., George, V., Ghouti, L., Giner, F., Ginther, N., Glynn, R., Golda, T., Griffiths, B., Harris, D. A., Jaw, H., Hanchanale, V., Harji, D. P., Helewa, R. M., Hellawell, G., Heriot, A. G., Hochman, D., Hohenberger, W., Holm, T., Hompes, R., Jenkins, J. T., Kaffenberger, S., Kandaswamy, G. V., Kapur, S., Kanemitsu, Y., Kelley, S. R., Keller, D. S., Khan, M. S., Kim, H., Kim, H. J., Koh, C. E., Nfm, K., Kokelaar, R., Kristensen, H. O., Kroon, H. M., Kusters, M., Lago, V., Larsen, S. G., Larson, D. W., Law, W. L., Laurberg, S., Lee, P. J., Limbert, M., Lydrup, M. L., Lyons, A., Lynch, A. C., Mantyh, C., Mathis, K. L., Cfs, M., Martling, A., Wjhj, M., Merkel, S., Mehta, A. M., Mcarthur, D. R., Mcdermott, F. D., Mcgrath, J. S., Malde, S., Mirnezami, A., Jrt, M., Morton, J. R., Mullaney, T. G., Negoi, I., Jwm, N., Ng, J. L., Nguyen, B., Nielsen, M. B., Gap, N., Nilsson, P. J., Oliver, A., O'Dwyer, S. T., Palmer, G., Pappou, E., Park, J., Patsouras, D., Pellino, G., Peterson, A. C., Poggioli, G., Proud, D., Quinn, M., Quyn, A., Radwan, R. W., Rasmussen, P. C., Rausa, E., Regenbogen, S. E., Renehan, A., Rocha, R., Rochester, M., Rohila, J., Rothbarth, J., Rottoli, M., Roxburgh, C., Hjt, R., Ryan, E. J., Safar, B., Sagar, P. M., Sahai, A., Saklani, A., Sammour, T., Sayyed, R., Amp, S., Schwarzkopf, E., Scripcariu, V., Selvasekar, C., Shaikh, I., Shida, D., Simpson, A., Smart, N. J., Smart, P., Smith, J. J., Solbakken, A. M., Solomon, M. J., Sorensen, M. M., Steele, S. R., Steffens, D., Stitzenberg, K., Stocchi, L., Stylianides, N. A., Swartling, T., Sumrien, H., Sutton, P. A., Swartking, T., Tan, E. J., Taylor, C., Teras, J., Thurairaja, R., Toh, E. L., Tsarkov, P., Tsukada, Y., Tsukamoto, S., Tuech, J. J., Turner, W. H., Tuynman, J. B., van Ramshorst, G. H., van Zoggel, D., Vasquez-Jimenez, W., Verhoef, C., Vizzielli, G., Elk, V., Uehara, K., Wakeman, C., Warrier, S., Wasmuth, H. H., Weber, K., Weiser, M. R., Jmd, W., Wild, J., Wilson, M., Wolthuis, A., Yano, H., Yip, B., Yip, J., Yoo, R. N., Zappa, M. A., Winter, D. C., Tekkis, P. P., and Surgery

Subjects
Oncology, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Locally advanced, MEDLINE, Comorbidity, COVID-19 - advanced - recurrent - primary - rectal cancer, SDG 3 - Good Health and Well-being, Internal medicine, Pandemic, Correspondence, medicine, Combined Modality Therapy, Humans, General, Pandemics, Recurrent Rectal Cancer, Neoplasm Staging, business.industry, Rectal Neoplasms, SARS-CoV-2, COVID-19, medicine.disease, Neoplasm staging, Surgery, Neoplasm Recurrence, Local, business
Published
2020

25. Predicting outcomes of pelvic exenteration using machine learning

Author

Dudurych I., Kelly M. E., Aalbers A. G. J., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K. K., Aziz O., Baker R. P., Bali M., Baseckas G., Bebington B., Bedford M., Bednarski B. K., Beets G. L., Berg P. L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A. B., Brunner M., Buchwald P., Bui A., Burgess A., Burger J. W. A., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Chan K. K. L., Chang G. J., Chew M. H., Chok A. K., Chong P., Christensen H. K., Clouston H., Codd M., Collins D., Colquhoun A. J., Corr A., Coscia M., Coyne P. E., Creavin B., Croner R. S., Damjanovic L., Daniels I. R., Davies M., Davies R. J., Delaney C. P., Wilt J. H. W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E. J., Duff M., Eglinton T., Enrique-Navascues J. M., Espin-Basany E., Evans M. D., Fearnhead N. S., Flatmark K., Fleming F., Frizelle F. A., Gallego M. A., Garcia-Granero E., Garcia-Sabrido J. L., Gentilini L., George M. L., George V., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D. A., Hagemans J. A. W., Hanchanale V., Harji D. P., Helewa R. M., Heriot A. G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J. T., Kaffenberger S., Kandaswamy G. V., Kapur S., Kanemitsu Y., Kelley S. R., Keller D. S., Khan M. S., Kiran R. P., Kim H., Kim H. J., Koh C. E., Kok N. F. M., Kokelaar R., Kontovounisios C., Kristensen H. O., Kroon H. M., Kusters M., Lago V., Larsen S. G., Larson D. W., Law W. L., Laurberg S., Lee P. J., Limbert M., Lydrup M. L., Lyons A., Lynch A. C., Mantyh C., Mathis K. L., Margues C. F. S., Martling A., Meijerink W. J. H. J., Merkel S., Mehta A. M., McArthur D. R., McDermott F. D., McGrath J. S., Malde S., Mirnezami A., Monson J. R. T., Morton J. R., Mullaney T. G., Negoi I., Neto J. W. M., Nguyen B., Nielsen M. B., Nieuwenhuijzen G. A. P., Nilsson P. J., Oliver A., O'Connell P. R., O'Dwyer S. T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A. C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R. W., Rasheed S., Rasmussen P. C., Regenbogen S. E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Rutten H. J. T., Ryan E. J., Safar B., Sagar P. M., Sahai A., Saklani A., Sammour T., Sayyed R., Schizas A. M. P., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shellawell G., Shida D., Simpson A., Smart N. J., Smart P., Smith J. J., Solbakken A. M., Solomon M. J., Sorensen M. M., Steele S. R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N. A., Swartling T., Sumrien H., Sutton P. A., Swartking T., Tan E. J., Taylor C., Tekkis P. P., Teras J., Thurairaja R., Toh E. L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J. J., Turner W. H., Tuynman J. B., van Ramshorst G. H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Voogt E. L. K., Uehara K., Wakeman C., Warrier S., Wasmuth H. H., Weber K., Weiser M. R., Wheeler J. M. D., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R. N., Winter D. C., Dudurych I., Kelly M.E., Aalbers A.G.J., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K.K., Aziz O., Baker R.P., Bali M., Baseckas G., Bebington B., Bedford M., Bednarski B.K., Beets G.L., Berg P.L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A.B., Brunner M., Buchwald P., Bui A., Burgess A., Burger J.W.A., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Chan K.K.L., Chang G.J., Chew M.H., Chok A.K., Chong P., Christensen H.K., Clouston H., Codd M., Collins D., Colquhoun A.J., Corr A., Coscia M., Coyne P.E., Creavin B., Croner R.S., Damjanovic L., Daniels I.R., Davies M., Davies R.J., Delaney C.P., Wilt J.H.W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E.J., Duff M., Eglinton T., Enrique-Navascues J.M., Espin-Basany E., Evans M.D., Fearnhead N.S., Flatmark K., Fleming F., Frizelle F.A., Gallego M.A., Garcia-Granero E., Garcia-Sabrido J.L., Gentilini L., George M.L., George V., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D.A., Hagemans J.A.W., Hanchanale V., Harji D.P., Helewa R.M., Heriot A.G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J.T., Kaffenberger S., Kandaswamy G.V., Kapur S., Kanemitsu Y., Kelley S.R., Keller D.S., Khan M.S., Kiran R.P., Kim H., Kim H.J., Koh C.E., Kok N.F.M., Kokelaar R., Kontovounisios C., Kristensen H.O., Kroon H.M., Kusters M., Lago V., Larsen S.G., Larson D.W., Law W.L., Laurberg S., Lee P.J., Limbert M., Lydrup M.L., Lyons A., Lynch A.C., Mantyh C., Mathis K.L., Margues C.F.S., Martling A., Meijerink W.J.H.J., Merkel S., Mehta A.M., McArthur D.R., McDermott F.D., McGrath J.S., Malde S., Mirnezami A., Monson J.R.T., Morton J.R., Mullaney T.G., Negoi I., Neto J.W.M., Nguyen B., Nielsen M.B., Nieuwenhuijzen G.A.P., Nilsson P.J., Oliver A., O'Connell P.R., O'Dwyer S.T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A.C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R.W., Rasheed S., Rasmussen P.C., Regenbogen S.E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Rutten H.J.T., Ryan E.J., Safar B., Sagar P.M., Sahai A., Saklani A., Sammour T., Sayyed R., Schizas A.M.P., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shellawell G., Shida D., Simpson A., Smart N.J., Smart P., Smith J.J., Solbakken A.M., Solomon M.J., Sorensen M.M., Steele S.R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N.A., Swartling T., Sumrien H., Sutton P.A., Swartking T., Tan E.J., Taylor C., Tekkis P.P., Teras J., Thurairaja R., Toh E.L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J.J., Turner W.H., Tuynman J.B., van Ramshorst G.H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Voogt E.L.K., Uehara K., Wakeman C., Warrier S., Wasmuth H.H., Weber K., Weiser M.R., Wheeler J.M.D., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R.N., Winter D.C., Surgery, Dudurych, I., Kelly, M. E., Aalbers, A. G. J., Abdul Aziz, N., Abecasis, N., Abraham-Nordling, M., Akiyoshi, T., Alberda, W., Albert, M., Andric, M., Angenete, E., Antoniou, A., Auer, R., Austin, K. K., Aziz, O., Baker, R. P., Bali, M., Baseckas, G., Bebington, B., Bedford, M., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Boyle, K., Bordeianou, L., Bremers, A. B., Brunner, M., Buchwald, P., Bui, A., Burgess, A., Burger, J. W. A., Burling, D., Burns, E., Campain, N., Carvalhal, S., Castro, L., Caycedo-Marulanda, A., Chan, K. K. L., Chang, G. J., Chew, M. H., Chok, A. K., Chong, P., Christensen, H. K., Clouston, H., Codd, M., Collins, D., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Croner, R. S., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Delaney, C. P., Wilt, J. H. W., Denost, Q., Deutsch, C., Dietz, D., Domingo, S., Dozois, E. J., Duff, M., Eglinton, T., Enrique-Navascues, J. M., Espin-Basany, E., Evans, M. D., Fearnhead, N. S., Flatmark, K., Fleming, F., Frizelle, F. A., Gallego, M. A., Garcia-Granero, E., Garcia-Sabrido, J. L., Gentilini, L., George, M. L., George, V., Ghouti, L., Giner, F., Ginther, N., Glynn, R., Golda, T., Griffiths, B., Harris, D. A., Hagemans, J. A. W., Hanchanale, V., Harji, D. P., Helewa, R. M., Heriot, A. G., Hochman, D., Hohenberger, W., Holm, T., Hompes, R., Jenkins, J. T., Kaffenberger, S., Kandaswamy, G. V., Kapur, S., Kanemitsu, Y., Kelley, S. R., Keller, D. S., Khan, M. S., Kiran, R. P., Kim, H., Kim, H. J., Koh, C. E., Kok, N. F. M., Kokelaar, R., Kontovounisios, C., Kristensen, H. O., Kroon, H. M., Kusters, M., Lago, V., Larsen, S. G., Larson, D. W., Law, W. L., Laurberg, S., Lee, P. J., Limbert, M., Lydrup, M. L., Lyons, A., Lynch, A. C., Mantyh, C., Mathis, K. L., Margues, C. F. S., Martling, A., Meijerink, W. J. H. J., Merkel, S., Mehta, A. M., Mcarthur, D. R., Mcdermott, F. D., Mcgrath, J. S., Malde, S., Mirnezami, A., Monson, J. R. T., Morton, J. R., Mullaney, T. G., Negoi, I., Neto, J. W. M., Nguyen, B., Nielsen, M. B., Nieuwenhuijzen, G. A. P., Nilsson, P. J., Oliver, A., O'Connell, P. R., O'Dwyer, S. T., Palmer, G., Pappou, E., Park, J., Patsouras, D., Pellino, G., Peterson, A. C., Poggioli, G., Proud, D., Quinn, M., Quyn, A., Radwan, R. W., Rasheed, S., Rasmussen, P. C., Regenbogen, S. E., Renehan, A., Rocha, R., Rochester, M., Rohila, J., Rothbarth, J., Rottoli, M., Roxburgh, C., Rutten, H. J. T., Ryan, E. J., Safar, B., Sagar, P. M., Sahai, A., Saklani, A., Sammour, T., Sayyed, R., Schizas, A. M. P., Schwarzkopf, E., Scripcariu, V., Selvasekar, C., Shaikh, I., Shellawell, G., Shida, D., Simpson, A., Smart, N. J., Smart, P., Smith, J. J., Solbakken, A. M., Solomon, M. J., Sorensen, M. M., Steele, S. R., Steffens, D., Stitzenberg, K., Stocchi, L., Stylianides, N. A., Swartling, T., Sumrien, H., Sutton, P. A., Swartking, T., Tan, E. J., Taylor, C., Tekkis, P. P., Teras, J., Thurairaja, R., Toh, E. L., Tsarkov, P., Tsukada, Y., Tsukamoto, S., Tuech, J. J., Turner, W. H., Tuynman, J. B., van Ramshorst, G. H., van Zoggel, D., Vasquez-Jimenez, W., Verhoef, C., Vizzielli, G., Voogt, E. L. K., Uehara, K., Wakeman, C., Warrier, S., Wasmuth, H. H., Weber, K., Weiser, M. R., Wheeler, J. M. D., Wild, J., Wilson, M., Wolthuis, A., Yano, H., Yip, B., Yip, J., Yoo, R. N., and Winter, D. C.

Subjects
Artificial intelligence, medicine.medical_treatment, Machine learning, computer.software_genre, Logistic regression, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], SDG 3 - Good Health and Well-being, Medicine, Humans, Pelvic exenteration, Receiver operating characteristic, Artificial neural network, business.industry, Rectal Neoplasms, Deep learning, Gastroenterology, Prognosis, pelvic exenteration, Support vector machine, machine learning, Test set, colorectal surgery, Neoplasm Recurrence, Local, business, computer, Predictive modelling, artificial neural network
Abstract

Aim: We aim to compare machine learning with neural network performance in predicting R0 resection (R0), length of stay >14days (LOS), major complication rates at 30days postoperatively (COMP) and survival greater than 1 year (SURV) for patients having pelvic exenteration for locally advanced and recurrent rectal cancer. Method: A deep learning computer was built and the programming environment was established. The PelvEx Collaborative database was used which contains anonymized data on patients who underwent pelvic exenteration for locally advanced or locally recurrent colorectal cancer between 2004 and 2014. Logistic regression, a support vector machine and an artificial neural network (ANN) were trained. Twenty per cent of the data were used as a test set for calculating prediction accuracy for R0, LOS, COMP and SURV. Model performance was measured by plotting receiver operating characteristic (ROC) curves and calculating the area under the ROC curve (AUROC). Results: Machine learning models and ANNs were trained on 1147 cases. The AUROC for all outcome predictions ranged from 0.608 to 0.793 indicating modest to moderate predictive ability. The models performed best at predicting LOS >14days with an AUROC of 0.793 using preoperative and operative data. Visualized logistic regression model weights indicate a varying impact of variables on the outcome in question. Conclusion: This paper highlights the potential for predictive modelling of large international databases. Current data allow moderate predictive ability of both complex ANNs and more classic methods.

Published
2020

26. Perioperative management and anaesthetic considerations in pelvic exenterations using Delphi methodology: results from the PelvEx Collaborative

Author

PelvEx Collaborative, [missing], Chok, A Y, Oliver, A, Rasheed, S, Tan, E J, Kelly, M E, Aalbers, A G J, Abdul Aziz, N, Abecasis, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Albert, M, Andric, M, Angenete, E, Antoniou, A, Auer, R, Austin, K K, Aziz, O, Baker, R P, Bali, M, Baseckas, G, Bebington, B, Bedford, M, Bednarski, B K, Beets, G L, Berg, P L, Beynon, J, Biondo, S, Boyle, K, Bordeianou, L, Bremers, A B, Brunner, M, Buchwald, P, Bui, A, Burgess, A, Burger, J W A, Burling, D, Burns, E, Campain, N, Carvalhal, S, Castro, L, Caycedo-Marulanda, A, Chan, K K L, Chang, G J, Chew, M H, Chong, P, Christensen, H K, Clouston, H, Codd, M, Collins, D, Colquhoun, A J, Corr, A, Coscia, M, Coyne, P E, Creavin, B, Croner, R S, Damjanovic, L, Daniels, I R, Davies, M, Davies, R J, Delaney, C P, de Wilt, J H W, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, E J, Duff, M, Eglinton, T, Enrique-Navascues, J M, Espin-Basany, E, Evans, M D, Fearnhead, N S, Flatmark, K, Fleming, F, Frizelle, F A, Gallego, M A, Garcia-Granero, E, Garcia-Sabrido, J L, Gentilini, L, George, M L, George, V, Ghouti, L, Giner, F, Ginther, N, Glynn, R, Golda, T, Griffiths, B, Harris, D A, Hagemans, J A W, Hanchanale, V, Harji, D P, Helewa, R M, Hellawell, G, Heriot, A G, Hochman, D, Hohenberger, W, Holm, T, Holmström, A, Hompes, R, Jenkins, J T, Kaffenberger, S, Kandaswamy, G V, Kapur, S, Kanemitsu, Y, Kelley, S R, Keller, D S, Khan, M S, Kim, H, Kim, H J, Koh, C E, Kok, N F M, Kokelaar, R, Kontovounisios, C, Kristensen, H Ø, Kroon, H M, Kusters, M, Lago, V, Larsen, S G, Larson, D W, Law, W L, Laurberg, S, Lee, P J, Limbert, M, Lydrup, M L, Lyons, A, Lynch, A C, Mantyh, C, Mathis, K L, Margues, C F S, Martling, A, Meijerink, W J H J, Merkel, S, Mehta, A M, McArthur, D R, McDermott, F D, McGrath, J S, Malde, S, Mirnezami, A, Monson, J R T, Morton, J R, Mullaney, T G, Negoi, I, Neto, J W M, Nguyen, B, Nielsen, M B, Nieuwenhuijzen, G A P, Nilsson, P J, O’Dwyer, S T, Palmer, G, Pappou, E, Park, J, Patsouras, D, Pellino, G, Peterson, A C, Poggioli, G, Proud, D, Quinn, M, Quyn, A, Radwan, R W, Rasmussen, P C, Rausa, E, Regenbogen, S E, Renehan, A, Rocha, R, Rochester, M, Rohila, J, Rothbarth, J, Rottoli, M, Roxburgh, C, Rutten, H J T, Ryan, É J, Safar, B, Sagar, P M, Sahai, A, Saklani, A, Sammour, T, Sayyed, R, Schizas, A M P, Schwarzkopf, E, Scripcariu, V, Selvasekar, C, Shaikh, I, Shida, D, Simpson, A, Smart, N J, Smart, P, Smith, J J, Solbakken, A M, Solomon, M J, Sørensen, M M, Steele, S R, Steffens, D, Stitzenberg, K, Stocchi, L, Stylianides, N A, Swartling, T, Sumrien, H, Sutton, P A, Swartking, T, Taylor, C, Teras, J, Thurairaja, R, Toh, E L, Tsarkov, P, Tsukada, Y, Tsukamoto, S, Tuech, J J, Turner, W H, Tuynman, J B, van Ramshorst, Gabriëlle, Zoggel, D van, Vasquez-Jimenez, W, Verhoef, C, Vizzielli, G, Voogt, E L K, Uehara, K, Wakeman, C, Warrier, S, Wasmuth, H H, Weber, K, Weiser, M R, Wheeler, J M D, Wild, J, Wilson, M, Wolthuis, A, Yano, H, Yip, B, Yip, J, Yoo, R N, Winter, D C, Tekkis, P P, Surgery, Chok, A Y, Oliver, A, Rasheed, S, Tan, E J, Kelly, M E, Aalbers, A G J, Abdul Aziz, N, Abecasis, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Albert, M, Andric, M, Angenete, E, Antoniou, A, Auer, R, Austin, K K, Aziz, O, Baker, R P, Bali, M, Baseckas, G, Bebington, B, Bedford, M, Bednarski, B K, Beets, G L, Berg, P L, Beynon, J, Biondo, S, Boyle, K, Bordeianou, L, Bremers, A B, Brunner, M, Buchwald, P, Bui, A, Burgess, A, Burger, J W A, Burling, D, Burns, E, Campain, N, Carvalhal, S, Castro, L, Caycedo-Marulanda, A, Chan, K K L, Chang, G J, Chew, M H, Chong, P, Christensen, H K, Clouston, H, Codd, M, Collins, D, Colquhoun, A J, Corr, A, Coscia, M, Coyne, P E, Creavin, B, Croner, R S, Damjanovic, L, Daniels, I R, Davies, M, Davies, R J, Delaney, C P, de Wilt, J H W, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, E J, Duff, M, Eglinton, T, Enrique-Navascues, J M, Espin-Basany, E, Evans, M D, Fearnhead, N S, Flatmark, K, Fleming, F, Frizelle, F A, Gallego, M A, Garcia-Granero, E, Garcia-Sabrido, J L, Gentilini, L, George, M L, George, V, Ghouti, L, Giner, F, Ginther, N, Glynn, R, Golda, T, Griffiths, B, Harris, D A, Hagemans, J A W, Hanchanale, V, Harji, D P, Helewa, R M, Hellawell, G, Heriot, A G, Hochman, D, Hohenberger, W, Holm, T, Holmström, A, Hompes, R, Jenkins, J T, Kaffenberger, S, Kandaswamy, G V, Kapur, S, Kanemitsu, Y, Kelley, S R, Keller, D S, Khan, M S, Kim, H, Kim, H J, Koh, C E, Kok, N F M, Kokelaar, R, Kontovounisios, C, Kristensen, H Ø, Kroon, H M, Kusters, M, Lago, V, Larsen, S G, Larson, D W, Law, W L, Laurberg, S, Lee, P J, Limbert, M, Lydrup, M L, Lyons, A, Lynch, A C, Mantyh, C, Mathis, K L, Margues, C F S, Martling, A, Meijerink, W J H J, Merkel, S, Mehta, A M, McArthur, D R, McDermott, F D, McGrath, J S, Malde, S, Mirnezami, A, Monson, J R T, Morton, J R, Mullaney, T G, Negoi, I, Neto, J W M, Nguyen, B, Nielsen, M B, Nieuwenhuijzen, G A P, Nilsson, P J, O’Dwyer, S T, Palmer, G, Pappou, E, Park, J, Patsouras, D, Pellino, G, Peterson, A C, Poggioli, G, Proud, D, Quinn, M, Quyn, A, Radwan, R W, Rasmussen, P C, Rausa, E, Regenbogen, S E, Renehan, A, Rocha, R, Rochester, M, Rohila, J, Rothbarth, J, Rottoli, M, Roxburgh, C, Rutten, H J T, Ryan, É J, Safar, B, Sagar, P M, Sahai, A, Saklani, A, Sammour, T, Sayyed, R, Schizas, A M P, Schwarzkopf, E, Scripcariu, V, Selvasekar, C, Shaikh, I, Shida, D, Simpson, A, Smart, N J, Smart, P, Smith, J J, Solbakken, A M, Solomon, M J, Sørensen, M M, Steele, S R, Steffens, D, Stitzenberg, K, Stocchi, L, Stylianides, N A, Swartling, T, Sumrien, H, Sutton, P A, Swartking, T, Taylor, C, Teras, J, Thurairaja, R, Toh, E L, Tsarkov, P, Tsukada, Y, Tsukamoto, S, Tuech, J J, Turner, W H, Tuynman, J B, Ramshorst, G H van, Zoggel, D van, Vasquez-Jimenez, W, Verhoef, C, Vizzielli, G, Voogt, E L K, Uehara, K, Wakeman, C, Warrier, S, Wasmuth, H H, Weber, K, Weiser, M R, Wheeler, J M D, Wild, J, Wilson, M, Wolthuis, A, Yano, H, Yip, B, Yip, J, Yoo, R N, Winter, D C, Tekkis, P P, Mcarthur, D R, Mcdermott, F D, Mcgrath, J S, Psychiatrie & Neuropsychologie, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Faculteit FHML Centraal, Health Services Research, RS: CAPHRI - R1 - Ageing and Long-Term Care, RS: FdR IC Goederenrecht, School Office GROW, and Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
BLOOD-TRANSFUSION, CARDIAC RISK, AcademicSubjects/MED00910, medicine.medical_treatment, Delphi method, Computer-assisted web interviewing, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, 030202 anesthesiology, Multidisciplinary approach, Medicine and Health Sciences, Medicine, humans, RISK, COMPLICATIONS, Perioperative management - anaesthetic - pelvic exenterations - rectal cancer - Delphi - PelvEx Collaborative, Manchester Cancer Research Centre, General Medicine, SYSTEMIC INFLAMMATORY RESPONSE, 030220 oncology & carcinogenesis, Original Article, Medical emergency, EPIDURAL-ANESTHESIA, AcademicSubjects/MED00010, Life Sciences & Biomedicine, Consensus, ENHANCED RECOVERY, Best practice, education, MEDLINE, patient care team/organization & administration, 03 medical and health sciences, anesthetics, Humans, MAJOR ABDOMINAL-SURGERY, METAANALYSIS, RECTAL-CANCER, Anesthetics, Patient Care Team, Science & Technology, Pelvic exenteration, business.industry, ResearchInstitutes_Networks_Beacons/mcrc, MORTALITY, LONG-TERM SURVIVAL, Perioperative, COMPARTMENT SYNDROME, medicine.disease, pelvic exenteration, Pelvic Exenteration, Subject-matter expert, consensus, Surgery, business
Abstract

Background The multidisciplinary perioperative and anaesthetic management of patients undergoing pelvic exenteration is essential for good surgical outcomes. No clear guidelines have been established, and there is wide variation in clinical practice internationally. This consensus statement consolidates clinical experience and best practice collectively, and systematically addresses key domains in the perioperative and anaesthetic management. Methods The modified Delphi methodology was used to achieve consensus from the PelvEx Collaborative. The process included one round of online questionnaire involving controlled feedback and structured participant response, two rounds of editing, and one round of web-based voting. It was held from December 2019 to February 2020. Consensus was defined as more than 80 per cent agreement, whereas less than 80 per cent agreement indicated low consensus. Results The final consensus document contained 47 voted statements, across six key domains of perioperative and anaesthetic management in pelvic exenteration, comprising preoperative assessment and preparation, anaesthetic considerations, perioperative management, anticipating possible massive haemorrhage, stress response and postoperative critical care, and pain management. Consensus recommendations were developed, based on consensus agreement achieved on 34 statements. Conclusion The perioperative and anaesthetic management of patients undergoing pelvic exenteration is best accomplished by a dedicated multidisciplinary team with relevant domain expertise in the setting of a specialized tertiary unit. This consensus statement has addressed key domains within the framework of current perioperative and anaesthetic management among patients undergoing pelvic exenteration, with an international perspective, to guide clinical practice, and has outlined areas for future clinical research., The PelvEx Collaborative consensus statement systematically addresses the perioperative and anaesthetic management of patients undergoing pelvic exenteration (PE). Using the modified Delphi methodology, recommendations across six key clinical domains comprising preoperative assessment and preparation, anaesthetic considerations, perioperative management, anticipating possible massive haemorrhage, stress response and postoperative critical care, and pain management were developed. pelvic exenteratio and recommendation

Published
2021
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27. The DICA Endoscopic Classification for Diverticular Disease of the Colon Shows a Significant Interobserver Agreement among Community Endoscopists: an International Study

Author

Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G. A., Biondi A., Biondo S., Cassieri C., Crucitti A., Dumitrascu D. L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P. G., Maconi G., Malfertheiner P., Mazzarri A., Mearin F., Milosavljevic T., Nardone G., de Oliveira E. C., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L. L., Walker M. M. D., Allegretta L., Altavilla N., Amaro P., Annunziata M. L., Barberio F., Basile G., Bedogni G., Belfiori V., Benvenuti S., Bertolami C., Bisello M., El Dammak M. B., Bozzi R., Buono M., Cambie G., Capezzuto E., Casamassima C., Chavoushian A., Ciofani R., Citarella C., Compare D., Cotruta B., D'amico F., Dulk M. D., Dyrda B. E., Festa V., Gallina S., Grasso R., Hanzel J., Taieb J. M., Lai M. A., Latella G., Lisi D., Lodi L., Marangi S., Mardegan A., Marlicz W., Maurano A., Milazzo G., Militaru V., Miraglia S., Monica F., Moskalev A., Natale A., Nicolas C., Pancetti A., Penna A., Pepe A. S., Pisano M., Pontone S., Prati M., Prisco A., Rando L., Hernandez E. R., Rosati O., Rossi G., Passoni G. R., Papa V., Nesme N. S., Schiffino L., Schillaci D., Selvaggi G., Taborchi F., Tornar A., Trebuna F., Triggiani C., Testai F. V., Vassallo R., Violi A., Tursi, A., Brandimarte, G., Di Mario, F., Lanas, A., Scarpignato, C., Bafutto, M., Barbara, G., Bassotti, G., Binda, G. A., Biondi, A., Biondo, S., Cassieri, C., Crucitti, A., Dumitrascu, D. L., Elisei, W., Escalante, R., Herszenyi, L., Kruis, W., Kupcinskas, J., Lahat, A., Lecca, P. G., Maconi, G., Malfertheiner, P., Mazzarri, A., Mearin, F., Milosavljevic, T., Nardone, G., de Oliveira, E. C., Papa, A., Papagrigoriadis, S., Pera, M., Persiani, R., Picchio, M., Regula, J., Stimac, D., Stollman, N., Strate, L. L., Walker, M. M. D., Allegretta, L., Altavilla, N., Amaro, P., Annunziata, M. L., Barberio, F., Basile, G., Bedogni, G., Belfiori, V., Benvenuti, S., Bertolami, C., Bisello, M., El Dammak, M. B., Bozzi, R., Buono, M., Cambie, G., Capezzuto, E., Casamassima, C., Chavoushian, A., Ciofani, R., Citarella, C., Compare, D., Cotruta, B., D'Amico, F., Dulk, M. D., Dyrda, B. E., Festa, V., Gallina, S., Grasso, R., Hanzel, J., Taieb, J. M., Lai, M. A., Latella, G., Lisi, D., Lodi, L., Marangi, S., Mardegan, A., Marlicz, W., Maurano, A., Milazzo, G., Militaru, V., Miraglia, S., Monica, F., Moskalev, A., Natale, A., Nicolas, C., Pancetti, A., Penna, A., Pepe, A. S., Pisano, M., Pontone, S., Prati, M., Prisco, A., Rando, L., Hernandez, E. R., Rosati, O., Rossi, G., Passoni, G. R., Papa, V., Nesme, N. S., Schiffino, L., Schillaci, D., Selvaggi, G., Taborchi, F., Tornar, A., Trebuna, F., Triggiani, C., Testai, F. V., Vassallo, R., Violi, A., Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G.A., Biondi A., Biondo S., Cassieri C., Crucitti A., Dumitrascu D.L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P.G., Maconi G., Malfertheiner P., Mazzari A., Mearin F., Milosavljevic T., Nardone G., Chavez De Oliveira E., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L.L., and Walker M.M.

Subjects
BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences, Diverticular Disease, Endoscopic classification, Video Recording, Colonoscopy, Gastroenterology, Severity of Illness Index, endoscopic classification, Diverticulum, classification, complications, Diverticular diseases, Endoscopy, methods, Colonic Diseases, 0302 clinical medicine, Community Health Services, Community Health Service, Observer Variation, 0303 health sciences, medicine.diagnostic_test, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti, agreement − colonoscopy − community setting − diverticular disease of the colon− endoscopic classification, 3. Good health, Diverticulosis, Malalties del còlon, Diverticular disease of the colon, Diverticular disease, 616.344-007.64 [udc], Community setting, 030211 gastroenterology & hepatology, Human, medicine.medical_specialty, Scoring system, Colonic Disease, Settore MED/12 - GASTROENTEROLOGIA, Reproducibility of Result, agreement, colonoscopy, community setting, diverticular disease of the colon, Agreement, 03 medical and health sciences, Internal medicine, Severity of illness, medicine, Diverticulosis, Colonic, Humans, Colonic diseases, 030304 developmental biology, Diverticular Diseases, business.industry, Colonoscòpia, Reproducibility of Results, medicine.disease, Inter-rater reliability, business, Kappa
Abstract

Background and Aims: The Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification of diverticulosis and diverticular disease (DD) is currently available. It scores severity of the disease as DICA 1, DICA 2 and DICA 3. Our aim was to assess the agreement on this classification in an international endoscopists community setting. Methods: A total of 96 doctors (82.9% endoscopists) independently scored a set of DD endoscopic videos. The percentages of overall agreement on DICA score and a free-marginal multirater kappa (κ) coefficient were reported as statistical measures of interrater agreement. Results: Overall agreement in using DICA was 91.8% with a free-marginal kappa of 88% (95% CI 80-95). The overall agreement levels were: DICA 1, 85.2%; DICA 2, 96.5%; DICA 3, 99.5%. The free marginal κ was: DICA 1 = 0.753, DICA 2 = 0.958, DICA 3 = 0.919. The agreement about the main endoscopic items was 83.4% (k 67%) for diverticular extension, 62.6% (k 65%) for number of diverticula for each district, 86.8% (k 82%) for presence of inflammation, and 98.5 (k 98%) for presence of complications. Conclusions: The overall interrater agreement in this study ranges from good to very good. DICA score is a simple and reproducible endoscopic scoring system for diverticulosis and DD.

Published
2019

35. Changing outcomes following pelvic exenteration for locally advanced and recurrent rectal cancer

Author

Kelly, M. E., Aalbers, A. G. J., Aziz, N. Abdul, Abraham-Nordling, M., Alberda, W., Antoniou, A., Austin, K. K., Baker, R., Bali, M., Baseckas, G., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Bordeianou, L., Brunner, M., Buchwald, P., Burger, J. W. A., Burling, D., Campain, N., Chan, K. K. L., Chang, G., Chew, M. H., Chong, P. C., Christensen, H. K., Codd, M., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., de Wilt, J. H. W., Denost, Q., Deutsch, C., Dietz, D., Dozois, E. J., Duff, M., Eglinton, T., Evans, M., Evans, M. D., Fearnhead, N. S., Frizelle, F. A., Garcia-Granero, E., Garcia-Sabrido, J. L., Gentilini, L., George, M. L., Glynn, R., Golda, T., Griffiths, B., Hagemans, J. A. W., Harji, D. P., Harris, D. A., Heriot, A. A. G., Hohenberger, W., Holm, T., Jenkins, J. T., Kanemitsu, Y., Kapur, S., Keller, D. S., Kelley, S. R., Kim, H., Koh, C. E., Kok, N. F. M., Kokelaar, R., Kontovounisios, C., Kusters, M., Larson, D. W., Laurberg, S., Law, W. L., Lee, P., Lydrup, M. L., Lynch, A. C., Martling, A., Mathis, K. L., Meijerink, W. J. H. J., Mentha, A. M., Merkel, S., McDermott, F. D., McGrath, J. S., Mihailo, A., Mirnezami, A., Morton, J. R., Mullaney, T. G., Nielsen, M. B., Nieuwenhuijzen, G. A. P., Nilsson, P. J., O'Connell, P. R., Palmer, G., Patsouras, D., Pellino, G., Poggioli, G., Quinn, M., Quyn, A., Radwan, R. W., Rasheed, S., Rasmussen, P. C., Rocha, R., Rothbarth, J., Roxburgh, C., Rutten, H. J. T., Ryan, E., Sagar, P. M., Sammour, T., Schizas, A. M. P., Schwarzkopf, E., Scripcariu, V, Shaikh, I, Shida, D., Simpson, A., Smart, N. J., Smith, J., Solomon, M. J., Sorensen, M. M., Steele, S. R., Steffens, D., Stocchi, L., Stylianides, N. A., Taylor, C., Tekkis, P. P., Tsukamoto, S., Turner, W. H., Tuynman, J. B., van Ramshorst, Gabriëlle, van Zoggel, D., Vasquez-Jimenez, W., Verhoef, C., Verstegen, M., Wakeman, C., Warrier, S., Wasmuth, H. H., Weiser, M. R., Wheeler, J. M. D., Wild, J., Winter, D. C., Yip, J., Kelly, M. E., Aalbers, A. G. J., Aziz, N. Abdul, Abraham‐Nordling, M., Alberda, W., Antoniou, A., Austin, K. K., Baker, R., Bali, M., Baseckas, G., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Bordeianou, L., Brunner, M., Buchwald, P., Burger, J. W. A., Burling, D., Campain, N., Chan, K. K. L., Chang, G., Chew, M. H., Chong, P. C., Christensen, H. K., Codd, M., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Wilt, J. H. W., Denost, Q., Deutsch, C., Dietz, D., Dozois, E. J., Duff, M., Eglinton, T., Evans, M., Evans, M.D., Fearnhead, N. S., Frizelle, F. A., Garcia‐Granero, E., Garcia‐Sabrido, J. L., Gentilini, L., George, M. L., Glynn, R., Golda, T., Griffiths, B., Hagemans, J. A.W., Harji, D. P., Harris, D. A., Heriot, A. A. G., Hohenberger, W., Holm, T., Jenkins, J. T., Kanemitsu, Y., Kapur, S., Keller, D. S., Kelley, S. R., Kim, H., Koh, C. E., Kok, N. F. M., Kokelaar, R., Kontovounisios, C., Kusters, M., Larson, D. W., Laurberg, S., Law, W. L., Lee, P., Lydrup, M. L., Lynch, A. C., Martling, A., Mathis, K. L., Meijerink, W. J. H. J., Mentha, A. M., Merkel, S., McDermott, F. D., McGrath, J. S., Mihailo, A., Mirnezami, A., Morton, J. R., Mullaney, T. G., Nielsen, M. B., Nieuwenhuijzen, G. A. P., Nilsson, P. J., O'Connell, P. R., Palmer, G., Patsouras, D., Pellino, G., Poggioli, G., Quinn, M., Quyn, A., Radwan, R. W., Rasheed, S., Rasmussen, P. C., Rocha, R., Rothbarth, J., Roxburgh, C., Rutten, H. J. T., Ryan, É., Sagar, P. M., Sammour, T., Schizas, A. M. P., Schwarzkopf, E., Scripcariu, V., Shaikh, I., Shida, D., Simpson, A., Smart, N. J., Smith, J., Solomon, M. J., Sørensen, M.M., Steele, S. R., Steffens, D., Stocchi, L., Stylianides, N. A., Taylor, C., Tekkis, P. P., Tsukamoto, S., Turner, W. H., Tuynman, J. B., Ramshorst, G. H., Zoggel, D., Vasquez‐Jimenez, W., Verhoef, C., Verstegen, M., Wakeman, C., Warrier, S., Wasmuth, H. H., Weiser, M. R., Wheeler, J. M. D., Wild, J., Winter, D. C., Yip, J., Kelly, Me, Aalbers, Agj, Aziz, Na, Abraham-Nordling, M, Alberda, W, Antoniou, A, Austin, Kk, Baker, R, Bali, M, Baseckas, G, Bednarski, Bk, Beets, Gl, Berg, Pl, Beynon, J, Biondo, S, Bordeianou, L, Brunner, M, Buchwald, P, Burger, Jwa, Burling, D, Campain, N, Chan, Kkl, Chang, G, Chew, Mh, Chong, Pc, Christensen, Hk, Codd, M, Colquhoun, Aj, Corr, A, Coscia, M, Coyne, Pe, Creavin, B, Damjanovic, L, Daniels, Ir, Davies, M, Davies, Rj, de Wilt, Jhw, Denost, Q, Deutsch, C, Dietz, D, Dozois, Ej, Duff, M, Eglinton, T, Evans, M, Evans, Md, Fearnhead, N, Frizelle, Fa, Garcia-Granero, E, Garcia-Sabrido, Jl, Gentilini, L, George, Ml, Glynn, R, Golda, T, Griffiths, B, Hagemans, Jaw, Harji, Dp, Harris, Da, Heriot, Aag, Hohenberger, W, Holm, T, Jenkins, Jt, Kanemitsu, Y, Kapur, S, Keller, D, Kelley, Sr, Kim, H, Koh, Ce, Kok, Nfm, Kokelaar, R, Kontovounisios, C, Kusters, M, Larson, Dw, Laurberg, S, Law, Wl, Lee, P, Lydrup, Ml, Lynch, Ac, Martling, A, Mathis, Kl, Meijerink, Wjhj, Mentha, Am, Merkel, S, Mcdermott, Fd, Mcgrath, J, Mihailo, A, Mirnezami, A, Morton, Jr, Mullaney, Tg, Nielsen, Mb, Nieuwenhuijzen, Gap, Nilsson, Pj, O'Connell, Pr, Palmer, G, Patsouras, D, Pellino, G, Poggioli, G, Quinn, M, Quyn, A, Radwan, Rw, Rasheed, S, Rasmussen, Pc, Rocha, R, Rothbarth, J, Roxburgh, C, Rutten, Hjt, Ryan, E, Sagar, Pm, Sammour, T, Schizas, Amp, Schwarzkopf, E, Scripcariu, V, Shaikh, I, Shida, D, Simpson, A, Smart, Nj, Smith, J, Solomon, Mj, Sorensen, Mm, Steele, Sr, Steffens, D, Stocchi, L, Stylianides, Na, Taylor, C, Tekkis, Pp, Tsukamoto, S, Turner, Wh, Tuynman, Jb, van Ramshorst, Gh, van Zoggel, D, Vasquez-Jimenez, W, Verhoef, C, Verstegen, M, Wakeman, C, Warrier, S, Wasmuth, Hh, Weiser, Mr, Wheeler, Jmd, Wild, J, Winter, Dc, and Yip, J

Subjects
Male, Blood transfusion, Colorectal cancer, medicine.medical_treatment, Surgical Flaps, COLORECTAL-CANCER, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Postoperative Complications, Retrospective Studie, Medicine and Health Sciences, Mortality rate, General Medicine, Middle Aged, Treatment Outcome, medicine.anatomical_structure, HOSPITAL VOLUME, SURVIVAL, Original Article, Female, Life Sciences & Biomedicine, Human, medicine.medical_specialty, lcsh:Surgery, Rectum, Subgroup analysis, SDG 3 - Good Health and Well-being, medicine, Humans, Blood Transfusion, Retrospective Studies, Aged, Science & Technology, Pelvic exenteration, Rectal Neoplasms, business.industry, MORTALITY, PelvEx Collaborative, Retrospective cohort study, Original Articles, lcsh:RD1-811, Length of Stay, medicine.disease, SURGEON VOLUME, Pelvic Exenteration, Surgery, Surgical Flap, Postoperative Complication, Neoplasm Recurrence, Local, business, Complication
Abstract

Contains fulltext : 215764.pdf (Publisher’s version ) (Open Access) Background: Pelvic exenteration for locally advanced rectal cancer (LARC) and locally recurrent rectal cancer (LRRC) is technically challenging but increasingly performed in specialist centres. The aim of this study was to compare outcomes of exenteration over time. Methods: This was a multicentre retrospective study of patients who underwent exenteration for LARC and LRRC between 2004 and 2015. Surgical outcomes, including rate of bone resection, flap reconstruction, margin status and transfusion rates, were examined. Outcomes between higher- and lower-volume centres were also evaluated. Results: Some 2472 patients underwent pelvic exenteration for LARC and LRRC across 26 institutions. For LARC, rates of bone resection or flap reconstruction increased from 2004 to 2015, from 3.5 to 12.8 per cent, and from 12.0 to 29.4 per cent respectively. Fewer units of intraoperative blood were transfused over this interval (median 4 to 2 units; P = 0.040). Subgroup analysis showed that bone resection and flap reconstruction rates increased in lower- and higher-volume centres. R0 resection rates significantly increased in low-volume centres but not in high-volume centres over time (low-volume: from 62.5 to 80.0 per cent, P = 0.001; high-volume: from 83.5 to 88.4 per cent, P = 0.660). For LRRC, no significant trends over time were observed for bone resection or flap reconstruction rates. The median number of units of intraoperative blood transfused decreased from 5 to 2.5 units (P < 0.001). R0 resection rates did not increase in either low-volume (from 51.7 to 60.4 per cent; P = 0.610) or higher-volume (from 48.6 to 65.5 per cent; P = 0.100) centres. No significant differences in length of hospital stay, 30-day complication, reintervention or mortality rates were observed over time. Conclusion: Radical resection, bone resection and flap reconstruction rates were performed more frequently over time, while transfusion requirements decreased.

Published
2019

38. Multicentre propensity score-matched analysis of conventional versus extended abdominoperineal excision for low rectal cancer

Author

Ortiz, H., Ciga, M. A., Armendariz, P., Kreisler, E., Codina-Cazador, A., Gomez-Barbadillo, J., Garcia-Granero, E., Roig, J. V., Biondo, S., Lujan, J., Fraccalvieri, D., Armendáriz, P., de Miguel, M., Espí, A., Codina, A., Ruiz, M. D., Espin, E., Palasí, R., Parajo, A., Camps, I., Piñol, M., Pellicer, E., Viciano, V., Alonso, E., Pera, M., García, T., Casal, E., Garcia, J., Rodríguez, M., Reina, Á., Roig, J., Errasti, J., Múgica, J. A., Gomez, J., Rada, R., Orelogio, M., Uribe, N., de Dios Franco, J., Arroyo, A., Sierra, J. E., Hernandez, P., Paredes, J., Martínez, G., Garcia, M., Carreño, G., Cifuentes, J., Monzón, J., Maseda, O., Huerga, D., Pavel, C., Gris, F., Segura, I., Palma, P., Díaz, J. G., Jiménez, J. L., Pérez, F., Portugal, V., Bernal, J. C., Lluis, F., Capitán, L., Cáceres, N., Martínez, J., Estévez, A., Maestre, M. V., Díaz, J. M., Reig, M., Amaya, A., Carmona, J. A., Jiménez, F. J., Ribé i Serrat, D., Prieto, I., Garcia, D., de Francisco, González T., Turienzo, A., Martinez, M., del Valle, S., Parra, P., Romero, F., Garcea, A., de la O, Rodamilans X., Pérez, A., Ais, G., de Zarate, Ortiz L., Sánchez, J., Estevan, R., Sueiras, A., Lamiquiz, A., Larzabal, A., Die, J., Solana, A., Blanco, F. J., Lage, A. M., Domínguez, J. L., Dujovne, P., Palencia, N., García, R., Adell, R., Martínez, R., Huidobro, A. M., Pastor, C., Garijo, J. Á., Carrillo, Á., del Coral de la Vega, M., and López, M.

Published
2014
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39. Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project

Author

Pellino, G, Alos, R, Biondo, S, Codina-Cazador, A, Enriquez-Navascues, JM, Espin-Basany, E, Roig-Vila, JV, Cervantes, A, Garcia-Granero, E, Bollo J., and Pascual, Vicent Viciano

Subjects
Neoadjuvant treatment, Survival, Radiotherapy, Chemotherapy, T stage, Rectal cancer, Prognosis, TNM
Abstract

Introduction: Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. Method: This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I) 2006-2009; II) 2010-2013; III) 2014-2017. Survival analyses were run for 3-year survival in timeframes I-II. Results: Out of 14,391 patients,8871 (61.6%) received neoadjuvant treatment. Long-course chemo/ radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy +/- chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11 cm) increased over time (31.5%vs 34.5% vs 38.6%, p = 0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p = 0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3% and 5.5% (p = 0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59-0.87, Cochrane-Mantel-Haenszel P = 0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p < 0.0001), and cancer-specific survival (p < 0.0001). The survival benefit was smaller in upper third cancers. Conclusion: There was an increasing trend and a potential overuse of neoadjuvant treatment in cancer of the upper rectum. Most ypN0 patients received postoperative treatment. Involvement of CRM in lower third tumors was reduced after neoadjuvant treatment. Stage III and MRcN thorn benefited the most. (C) 2020 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Published
2021

40. Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project

Author

Pellino G, Alós R, Biondo S, Codina-Cazador A, Enríquez-Navascues JM, Espín-Basany E, Roig-Vila JV, Cervantes A, García-Granero E, and Spanish Rectal Cancer Project collaborators

Subjects
Neoadjuvant treatment, Radiotherapy, Survival, Chemotherapy, T stage, Rectal cancer, Prognosis, TNM
Abstract

INTRODUCTION: Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. METHOD: This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I)2006-2009; II)2010-2013; III)2014-2017. Survival analyses were run for 3-year survival in timeframes I-II. RESULTS: Out of 14,391 patients,8871 (61.6%) received neoadjuvant treatment. Long-course chemo/radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy?±?chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11?cm) increased over time (31.5%vs 34.5%vs 38.6%,p?=?0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p?=?0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3%and 5.5% (p?=?0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59-0.87, Cochrane-Mantel-Haenszel P?=?0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p?0.0001), and cancer-specific survival (p?

Published
2021

42. Prevalence of nodal involvement in rectal cancer after chemoradiotherapy

Author

Haak, H E, primary, Beets, G L, additional, Peeters, K, additional, Nelemans, P J, additional, Valentini, V, additional, Rödel, C, additional, Kuo, L, additional, Calvo, F A, additional, Garcia-Aguilar, J, additional, Glynne-Jones, R, additional, Pucciarelli, S, additional, Suarez, J, additional, Theodoropoulos, G, additional, Biondo, S, additional, Lambregts, D M J, additional, Beets-Tan, R G H, additional, and Maas, M, additional

Published
2021
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43. Prevalence of nodal involvement in rectal cancer after chemoradiotherapy

Author

Haak, H.E., Haak, H.E., Beets, G.L., Peeters, K., Nelemans, P.J., Valentini, V., Rodel, C., Kuo, L., Calvo, F.A., Garcia-Aguilar, J., Glynne-Jones, R., Pucciarelli, S., Suarez, J., Theodoropoulos, G., Biondo, S., Lambregts, D.M.J., Beets-Tan, R.G.H., Maas, M., Haak, H.E., Haak, H.E., Beets, G.L., Peeters, K., Nelemans, P.J., Valentini, V., Rodel, C., Kuo, L., Calvo, F.A., Garcia-Aguilar, J., Glynne-Jones, R., Pucciarelli, S., Suarez, J., Theodoropoulos, G., Biondo, S., Lambregts, D.M.J., Beets-Tan, R.G.H., and Maas, M.

Abstract

Background: The purpose of this study was to investigate the prevalence of ypN+ status according to ypT category in patients with locally advanced rectal cancer treated with chemoradiotherapy and total mesorectal excision, and to assess the impact of ypN+ on disease recurrence and survival by pooled analysis of individual-patient data.Methods: Individual-patient data from 10 studies of chemoradiotherapy for rectal cancer were included. Pooled rates of ypN+ disease were calculated with 95 per cent confidence interval for each ypT category. Kaplan-Meier and Cox regression analyses were undertaken to assess influence of ypN status on 5-year disease-free survival (DFS) and overall survival (OS).Results: Data on 1898 patients were included in the study. Median follow-up was 50 (range 0-219)months. The pooled rate of ypN+ disease was 7 per cent for ypT0, 12 per cent for ypT1, 17 per cent for ypT2, 40 per cent for ypT3, and 46 per cent for ypT4 tumours. Patients with ypN+ disease had lower 5-year DFS and OS (46.2 and 63.4 per cent respectively) than patients with ypN0 tumours (74.5 and 83.2 per cent) (P<0.001). Cox regression analyses showed ypN+ status to be an independent predictor of recurrence and death.Conclusion: Risk of nodal metastases (ypN+) after chemoradiotherapy increases with advancing ypT category and needs to be considered if an organ-preserving strategy is contemplated.Lay SummaryWhen patients are diagnosed with rectal cancer and the tumour grows beyond the rectal wall there is a high risk that the tumour has spread to nearby lymph nodes. This study showed that this relationship between tumour invasion depth and lymph node involvement is similar after treatment with (chemo)radiotherapy. Patients who have tumour cells remaining in the lymph nodes after (chemo) radiotherapy have a worse prognosis than patients who do not have cancer cells remaining in the lymph nodes. When an organ-preserving treatment is considered as an alternative therapy, this should b

Published
2021

44. Characteristics of Early-Onset vs Late-Onset Colorectal Cancer A Review

Author

Zaborowski, AM, Abdile, A, Adamina, M, Aigner, F, d'Allens, L, Allmer, C, Alvarez, A, Anula, R, Andric, M, Atallah, S, Bach, S, Bala, M, Barussaud, M, Bausys, A, Bebington, B, Beggs, A, Bellolio, F, Bennett, M-R, Berdinskikh, A, Bevan, V, Biondo, S, Bislenghi, G, Bludau, M, Boutall, A, Brouwer, N, Brown, C, Bruns, C, Buchanan, DD, Buchwald, P, Burger, JWA, Burlov, N, Campanelli, M, Capdepont, M, Carvello, M, Chew, H-H, Christoforidis, D, Clark, D, Climent, M, Cologne, KG, Contreras, T, Croner, R, Daniels, IR, Dapri, G, Davies, J, Delrio, P, Denost, Q, Deutsch, M, Dias, A, D'Hoore, A, Drozdov, E, Duek, D, Dunlop, M, Dziki, A, Edmundson, A, Efetov, S, El-Hussuna, A, Elliot, B, Emile, S, Espin, E, Evans, M, Faes, S, Faiz, O, Fleming, F, Foppa, C, Fowler, G, Frasson, M, Figueiredo, N, Forgan, T, Frizelle, F, Gadaev, S, Gellona, J, Glyn, T, Gong, J, Goran, B, Greenwood, E, Guren, MG, Guillon, S, Gutlic, I, Hahnloser, D, Hampel, H, Hanly, A, Hasegawa, H, Iversen, LH, Hill, A, Hill, J, Hoch, J, Hoffmeister, M, Hompes, R, Hurtado, L, Iaquinandi, F, Imbrasaite, U, Islam, R, Jafari, MD, Kanemitsu, Y, Karachun, A, Karimuddin, AA, Keller, DS, Kelly, J, Kennelly, R, Khrykov, G, Kocian, P, Koh, C, Kok, N, Knight, KA, Knol, J, Kontovounisios, C, Korner, H, Krivokapic, Z, Kronberger, I, Kroon, HM, Kryzauskas, M, Kural, S, Kusters, M, Lakkis, Z, Lankov, T, Larson, D, Lazar, G, Lee, K-Y, Lee, SH, Lefevre, JH, Lepisto, A, Lieu, C, Loi, L, Lynch, C, Maillou-Martinaud, H, Maroli, A, Martin, S, Martling, A, Matzel, KE, Mayol, J, McDermott, F, Meurette, G, Millan, M, Mitteregger, M, Moiseenko, A, Monson, JRT, Morarasu, S, Moritani, K, Moslein, G, Munini, M, Nahas, C, Nahas, S, Negoi, I, Novikova, A, Ocares, M, Okabayashi, K, Olkina, A, Onate-Ocana, L, Otero, J, Ozen, C, Pace, U, Juliao, GPS, Panaiotti, L, Panis, Y, Papamichael, D, Park, J, Patel, S, Uriburu, JCP, Pera, M, Perez, RO, Petrov, A, Pfeffer, F, Phang, PT, Poskus, T, Pringle, H, Proud, D, Raguz, I, Rama, N, Rasheed, S, Raval, MJ, Rega, D, Reissfelder, C, Meneses, JCR, Ris, F, Riss, S, Rodriguez-Zentner, H, Roxburgh, CS, Saklani, A, Salido, AJ, Sammour, T, Saraste, D, Schneider, M, Seishima, R, Sekulic, A, Seppala, T, Sheahan, K, Shine, R, Shlomina, A, Sica, GS, Singnomklao, T, Siragusa, L, Smart, N, Solis, A, Spinelli, A, Staiger, RD, Stamos, MJ, Steele, S, Sunderland, M, Tan, K-K, Tanis, PJ, Tekkis, P, Teklay, B, Tengku, S, Jimenez-Toscano, M, Tsarkov, P, Turina, M, Ulrich, A, Vailati, BB, van Harten, M, Verhoef, C, Warrier, S, Wexner, S, de Wilt, H, Weinberg, BA, Wells, C, Wolthuis, A, Xynos, E, You, N, Zakharenko, A, Zeballos, J, Winter, DC, Zaborowski, AM, Abdile, A, Adamina, M, Aigner, F, d'Allens, L, Allmer, C, Alvarez, A, Anula, R, Andric, M, Atallah, S, Bach, S, Bala, M, Barussaud, M, Bausys, A, Bebington, B, Beggs, A, Bellolio, F, Bennett, M-R, Berdinskikh, A, Bevan, V, Biondo, S, Bislenghi, G, Bludau, M, Boutall, A, Brouwer, N, Brown, C, Bruns, C, Buchanan, DD, Buchwald, P, Burger, JWA, Burlov, N, Campanelli, M, Capdepont, M, Carvello, M, Chew, H-H, Christoforidis, D, Clark, D, Climent, M, Cologne, KG, Contreras, T, Croner, R, Daniels, IR, Dapri, G, Davies, J, Delrio, P, Denost, Q, Deutsch, M, Dias, A, D'Hoore, A, Drozdov, E, Duek, D, Dunlop, M, Dziki, A, Edmundson, A, Efetov, S, El-Hussuna, A, Elliot, B, Emile, S, Espin, E, Evans, M, Faes, S, Faiz, O, Fleming, F, Foppa, C, Fowler, G, Frasson, M, Figueiredo, N, Forgan, T, Frizelle, F, Gadaev, S, Gellona, J, Glyn, T, Gong, J, Goran, B, Greenwood, E, Guren, MG, Guillon, S, Gutlic, I, Hahnloser, D, Hampel, H, Hanly, A, Hasegawa, H, Iversen, LH, Hill, A, Hill, J, Hoch, J, Hoffmeister, M, Hompes, R, Hurtado, L, Iaquinandi, F, Imbrasaite, U, Islam, R, Jafari, MD, Kanemitsu, Y, Karachun, A, Karimuddin, AA, Keller, DS, Kelly, J, Kennelly, R, Khrykov, G, Kocian, P, Koh, C, Kok, N, Knight, KA, Knol, J, Kontovounisios, C, Korner, H, Krivokapic, Z, Kronberger, I, Kroon, HM, Kryzauskas, M, Kural, S, Kusters, M, Lakkis, Z, Lankov, T, Larson, D, Lazar, G, Lee, K-Y, Lee, SH, Lefevre, JH, Lepisto, A, Lieu, C, Loi, L, Lynch, C, Maillou-Martinaud, H, Maroli, A, Martin, S, Martling, A, Matzel, KE, Mayol, J, McDermott, F, Meurette, G, Millan, M, Mitteregger, M, Moiseenko, A, Monson, JRT, Morarasu, S, Moritani, K, Moslein, G, Munini, M, Nahas, C, Nahas, S, Negoi, I, Novikova, A, Ocares, M, Okabayashi, K, Olkina, A, Onate-Ocana, L, Otero, J, Ozen, C, Pace, U, Juliao, GPS, Panaiotti, L, Panis, Y, Papamichael, D, Park, J, Patel, S, Uriburu, JCP, Pera, M, Perez, RO, Petrov, A, Pfeffer, F, Phang, PT, Poskus, T, Pringle, H, Proud, D, Raguz, I, Rama, N, Rasheed, S, Raval, MJ, Rega, D, Reissfelder, C, Meneses, JCR, Ris, F, Riss, S, Rodriguez-Zentner, H, Roxburgh, CS, Saklani, A, Salido, AJ, Sammour, T, Saraste, D, Schneider, M, Seishima, R, Sekulic, A, Seppala, T, Sheahan, K, Shine, R, Shlomina, A, Sica, GS, Singnomklao, T, Siragusa, L, Smart, N, Solis, A, Spinelli, A, Staiger, RD, Stamos, MJ, Steele, S, Sunderland, M, Tan, K-K, Tanis, PJ, Tekkis, P, Teklay, B, Tengku, S, Jimenez-Toscano, M, Tsarkov, P, Turina, M, Ulrich, A, Vailati, BB, van Harten, M, Verhoef, C, Warrier, S, Wexner, S, de Wilt, H, Weinberg, BA, Wells, C, Wolthuis, A, Xynos, E, You, N, Zakharenko, A, Zeballos, J, and Winter, DC

Abstract

IMPORTANCE: The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. OBSERVATIONS: Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. CONCLUSIONS AND RELEVANCE: The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.

Published
2021

45. Perioperative management and anaesthetic considerations in pelvic exenterations using Delphi methodology: results from the PelvEx Collaborative

Author

Chok, AY, Oliver, A, Rasheed, S, Tan, EJ, Kelly, ME, Aalbers, AGJ, Aziz, NA, Abecasis, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Albert, M, Andric, M, Angenete, E, Antoniou, A, Auer, R, Austin, KK, Aziz, O, Baker, RP, Bali, M, Baseckas, G, Bebington, B, Bedford, M, Bednarski, BK, Beets, GL, Berg, PL, Beynon, J, Biondo, S, Boyle, K, Bordeianou, L, Bremers, AB, Brunner, M, Buchwald, P, Bui, A, Burgess, A, Burger, JWA, Burling, D, Burns, E, Campain, N, Carvalhal, S, Castro, L, Caycedo-Marulanda, A, Chan, KKL, Chang, GJ, Chew, MH, Chong, P, Christensen, HK, Clouston, H, Codd, M, Collins, D, Colquhoun, AJ, Corr, A, Coscia, M, Coyne, PE, Creavin, B, Croner, RS, Damjanovic, L, Daniels, IR, Davies, M, Davies, RJ, Delaney, CP, de Wilt, JHW, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, EJ, Duff, M, Eglinton, T, Enrique-Navascues, JM, Espin-Basany, E, Evans, MD, Fearnhead, NS, Flatmark, K, Fleming, F, Frizelle, FA, Gallego, MA, Garcia-Granero, E, Garcia-Sabrido, JL, Gentilini, L, George, ML, George, V, Ghouti, L, Giner, F, Ginther, N, Glynn, R, Golda, T, Griffiths, B, Harris, DA, Hagemans, JAW, Hanchanale, V, Harji, DP, Helewa, RM, Hellawell, G, Heriot, AG, Hochman, D, Hohenberger, W, Holm, T, Holmstrom, A, Hompes, R, Jenkins, JT, Kaffenberger, S, Kandaswamy, G, Kapur, S, Kanemitsu, Y, Kelley, SR, Keller, DS, Khan, MS, Kim, H, Kim, HJ, Koh, CE, Kok, NFM, Kokelaar, R, Kontovounisios, C, Kristensen, HO, Kroon, HM, Kusters, M, Lago, V, Larsen, SG, Larson, DW, Law, WL, Laurberg, S, Lee, PJ, Limbert, M, Lydrup, ML, Lyons, A, Lynch, AC, Mantyh, C, Mathis, KL, Margues, CFS, Martling, A, Meijerink, WJHJ, Merkel, S, Mehta, AM, McArthur, DR, McDermott, FD, McGrath, JS, Malde, S, Mirnezami, A, Monson, JRT, Morton, JR, Mullaney, TG, Negoi, I, Neto, JWM, Nguyen, B, Nielsen, MB, Nieuwenhuijzen, GAP, Nilsson, PJ, O'Dwyer, ST, Palmer, G, Pappou, E, Park, J, Patsouras, D, Pellino, G, Peterson, AC, Poggioli, G, Proud, D, Quinn, M, Quyn, A, Radwan, RW, Rasmussen, PC, Rausa, E, Regenbogen, SE, Renehan, A, Rocha, R, Rochester, M, Rohila, J, Rothbarth, J, Rottoli, M, Roxburgh, C, Rutten, HJT, Ryan, EJ, Safar, B, Sagar, PM, Sahai, A, Saklani, A, Sammour, T, Sayyed, R, Schizas, AMP, Schwarzkopf, E, Scripcariu, V, Selvasekar, C, Shaikh, I, Shida, D, Simpson, A, Smart, NJ, Smart, P, Smith, JJ, Solbakken, AM, Solomon, MJ, Sorensen, MM, Steele, SR, Steffens, D, Stitzenberg, K, Stocchi, L, Stylianides, NA, Swartling, T, Sumrien, H, Sutton, PA, Swartking, T, Taylor, C, Teras, J, Thurairaja, R, Toh, EL, Tsarkov, P, Tsukada, Y, Tsukamoto, S, Tuech, JJ, Turner, WH, Tuynman, JB, van Ramshorst, GH, van Zoggel, D, Vasquez-Jimenez, W, Verhoef, C, Vizzielli, G, Voogt, ELK, Uehara, K, Wakeman, C, Warrier, S, Wasmuth, HH, Weber, K, Weiser, MR, Wheeler, JMD, Wild, J, Wilson, M, Wolthuis, A, Yano, H, Yip, B, Yip, J, Yoo, RN, Winter, DC, Tekkis, PP, Chok, AY, Oliver, A, Rasheed, S, Tan, EJ, Kelly, ME, Aalbers, AGJ, Aziz, NA, Abecasis, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Albert, M, Andric, M, Angenete, E, Antoniou, A, Auer, R, Austin, KK, Aziz, O, Baker, RP, Bali, M, Baseckas, G, Bebington, B, Bedford, M, Bednarski, BK, Beets, GL, Berg, PL, Beynon, J, Biondo, S, Boyle, K, Bordeianou, L, Bremers, AB, Brunner, M, Buchwald, P, Bui, A, Burgess, A, Burger, JWA, Burling, D, Burns, E, Campain, N, Carvalhal, S, Castro, L, Caycedo-Marulanda, A, Chan, KKL, Chang, GJ, Chew, MH, Chong, P, Christensen, HK, Clouston, H, Codd, M, Collins, D, Colquhoun, AJ, Corr, A, Coscia, M, Coyne, PE, Creavin, B, Croner, RS, Damjanovic, L, Daniels, IR, Davies, M, Davies, RJ, Delaney, CP, de Wilt, JHW, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, EJ, Duff, M, Eglinton, T, Enrique-Navascues, JM, Espin-Basany, E, Evans, MD, Fearnhead, NS, Flatmark, K, Fleming, F, Frizelle, FA, Gallego, MA, Garcia-Granero, E, Garcia-Sabrido, JL, Gentilini, L, George, ML, George, V, Ghouti, L, Giner, F, Ginther, N, Glynn, R, Golda, T, Griffiths, B, Harris, DA, Hagemans, JAW, Hanchanale, V, Harji, DP, Helewa, RM, Hellawell, G, Heriot, AG, Hochman, D, Hohenberger, W, Holm, T, Holmstrom, A, Hompes, R, Jenkins, JT, Kaffenberger, S, Kandaswamy, G, Kapur, S, Kanemitsu, Y, Kelley, SR, Keller, DS, Khan, MS, Kim, H, Kim, HJ, Koh, CE, Kok, NFM, Kokelaar, R, Kontovounisios, C, Kristensen, HO, Kroon, HM, Kusters, M, Lago, V, Larsen, SG, Larson, DW, Law, WL, Laurberg, S, Lee, PJ, Limbert, M, Lydrup, ML, Lyons, A, Lynch, AC, Mantyh, C, Mathis, KL, Margues, CFS, Martling, A, Meijerink, WJHJ, Merkel, S, Mehta, AM, McArthur, DR, McDermott, FD, McGrath, JS, Malde, S, Mirnezami, A, Monson, JRT, Morton, JR, Mullaney, TG, Negoi, I, Neto, JWM, Nguyen, B, Nielsen, MB, Nieuwenhuijzen, GAP, Nilsson, PJ, O'Dwyer, ST, Palmer, G, Pappou, E, Park, J, Patsouras, D, Pellino, G, Peterson, AC, Poggioli, G, Proud, D, Quinn, M, Quyn, A, Radwan, RW, Rasmussen, PC, Rausa, E, Regenbogen, SE, Renehan, A, Rocha, R, Rochester, M, Rohila, J, Rothbarth, J, Rottoli, M, Roxburgh, C, Rutten, HJT, Ryan, EJ, Safar, B, Sagar, PM, Sahai, A, Saklani, A, Sammour, T, Sayyed, R, Schizas, AMP, Schwarzkopf, E, Scripcariu, V, Selvasekar, C, Shaikh, I, Shida, D, Simpson, A, Smart, NJ, Smart, P, Smith, JJ, Solbakken, AM, Solomon, MJ, Sorensen, MM, Steele, SR, Steffens, D, Stitzenberg, K, Stocchi, L, Stylianides, NA, Swartling, T, Sumrien, H, Sutton, PA, Swartking, T, Taylor, C, Teras, J, Thurairaja, R, Toh, EL, Tsarkov, P, Tsukada, Y, Tsukamoto, S, Tuech, JJ, Turner, WH, Tuynman, JB, van Ramshorst, GH, van Zoggel, D, Vasquez-Jimenez, W, Verhoef, C, Vizzielli, G, Voogt, ELK, Uehara, K, Wakeman, C, Warrier, S, Wasmuth, HH, Weber, K, Weiser, MR, Wheeler, JMD, Wild, J, Wilson, M, Wolthuis, A, Yano, H, Yip, B, Yip, J, Yoo, RN, Winter, DC, and Tekkis, PP

Abstract

BACKGROUND: The multidisciplinary perioperative and anaesthetic management of patients undergoing pelvic exenteration is essential for good surgical outcomes. No clear guidelines have been established, and there is wide variation in clinical practice internationally. This consensus statement consolidates clinical experience and best practice collectively, and systematically addresses key domains in the perioperative and anaesthetic management. METHODS: The modified Delphi methodology was used to achieve consensus from the PelvEx Collaborative. The process included one round of online questionnaire involving controlled feedback and structured participant response, two rounds of editing, and one round of web-based voting. It was held from December 2019 to February 2020. Consensus was defined as more than 80 per cent agreement, whereas less than 80 per cent agreement indicated low consensus. RESULTS: The final consensus document contained 47 voted statements, across six key domains of perioperative and anaesthetic management in pelvic exenteration, comprising preoperative assessment and preparation, anaesthetic considerations, perioperative management, anticipating possible massive haemorrhage, stress response and postoperative critical care, and pain management. Consensus recommendations were developed, based on consensus agreement achieved on 34 statements. CONCLUSION: The perioperative and anaesthetic management of patients undergoing pelvic exenteration is best accomplished by a dedicated multidisciplinary team with relevant domain expertise in the setting of a specialized tertiary unit. This consensus statement has addressed key domains within the framework of current perioperative and anaesthetic management among patients undergoing pelvic exenteration, with an international perspective, to guide clinical practice, and has outlined areas for future clinical research.

Published
2021

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