Colon Cancer, Version 1.2017, NCCN Clinical Practice Guidelines in Oncology

Abstract

OverviewColorectal cancer (CRC) is the fourth most frequently diagnosed cancer and the second leading cause of cancer death in the United States. In 2016, an estimated 95,270 new cases of colon cancer and approximately 39,220 cases of rectal cancer will occur. During the same year, an estimated 49,190 people will die of colon and rectal cancer combined. AbstractThis portion of the NCCN Guidelines for Colon Cancer focuses on the use of systemic therapy in metastatic disease. Considerations for treatment selection among 32 different monotherapies and combination regimens in up to 7 lines of therapy have included treatment history, extent of disease, goals of treatment, the efficacy and toxicity profiles of the regimens, KRAS/NRAS mutational status, and patient comorbidities and preferences. Location of the primary tumor, the BRAF mutation status, and tumor microsatellite stability should also be considered in treatment decisions. J Natl Compr Canc Netw 2017;15(3): 370-398 NCCN Categories of Evidence and ConsensusCategory 1: Based upon high-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2A: Based upon lower-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2B: Based upon lower-level evidence, there is NCCN consensus that the intervention is appropriate. Category 3: Based upon any level of evidence, there is major NCCN disagreement that the intervention is appropriate. These guidelines are also available on the Internet. For the latest update, visit NCCN.org.

Clinico-pathological and oncological differences between right and left-sided colon cancer (stages I-III): analysis of 950 cases

“…These differences were first reported by Beart and Buffill (4,5) in the 1980s and 1990s and were corroborated by O'Dwyer (6) in stage IV disease in 2001. This phenomenon has aroused great interest, as tumor location influences survival in both stage III and IV disease (7).…”

Curative resectability of gastrointestinal cancer identified from iron deficiency anemia

“…The definition of curative treatment was curative surgery of stage I-III gastric or colorectal cancer (16,17).…”

A retrospective study of trifluridine/tipiracil in pretreated metastatic colorectal cancer patients in clinical practice

“…For mCRC patients who have progressed on these therapies, currently, we have three major options above participation in clinical trials: regorafenib, trifluridine/tipiracil (TAS-102) or best supportive care [3]. Regorafenib, an oral multitarget tyrosine kinase inhibitor with anti-angiogenic activity, was until few years ago the only drug to demonstrate superiority in terms of progression-free survival (PFS) and overall survival (OS) against placebo in a Phase III trial in later lines [4].…”