ESMO consensus guidelines for the management of patients with metastatic colorectal cancer

Abstract

Colorectal cancer (CRC) is one of the most common malignancies in Western countries. Over the last 20 years, and the last decade in particular, the clinical outcome for patients with metastatic CRC (mCRC) has improved greatly due not only to an increase in the number of patients being referred for and undergoing surgical resection of their localised metastatic disease but also to a more strategic approach to the delivery of systemic therapy and an expansion in the use of ablative techniques. This reflects the increase in the number of patients that are being managed within a multidisciplinary team environment and specialist cancer centres, and the emergence over the same time period not only of improved imaging techniques but also prognostic and predictive molecular markers. Treatment decisions for patients with mCRC must be evidence-based. Thus, these ESMO consensus guidelines have been developed based on the current available evidence to provide a series of evidence-based recommendations to assist in the treatment and management of patients with mCRC in this rapidly evolving treatment setting.

S3-Leitlinie – Kolorektales Karzinom

“…Zur Resektion von Lungenmetastasen liegen deutlich weniger Daten vor. Gleichwohl sollte ein chirurgisches Vorgehen in Betracht gezogen werden, wenn eine R0-Resektion erreicht werden kann [1048].…”

“…Die Symptom-Therapie soll zudem unter Einbeziehung der individuellen Patientenmerkmale (Alter, Geschlecht, Komorbidität, Symptombelastung) sowie der informierten Patientenentscheidung ausgewählt werden [1048].…”

Evolution and revolution of laparoscopic liver resection in Japan

“…Among patients in fair general condition with relatively few, small tumors, concurrent laparoscopic resection was safe and achieved long‐term outcomes comparable to those achieved by open surgery. In recent years, treatment with curative intent is actively performed by making modifications to liver resection and perioperative chemotherapy for unresectable liver metastases,96, 97 which has increased awareness of the utility of LLR as part of multidisciplinary therapy. Chemotherapy administered before liver resection may cause liver damage98, 99 and is considered disadvantageous for LLR.…”

Thermal Ablation of Lung Tumors: Focus on Microwave Ablation

“…When the metastases are completely resected, 20 -50 % of patients may reach long-time survival [100]. In the case of medically inoperable metastases originating from a colorectal carcinoma, either SBRT or thermal ablation is recommended by the guidelines of the European Society of Medical Oncology [101]. The largest and most recent pooled analysis by the working group Stereotactic Radiotherapy of the German Society for Radiation Oncology analyzed the outcomes of 700 patients with lung oligometastic disease treated with SBRT.…”