SEOM/SERAM consensus statement on radiological diagnosis, response assessment and follow-up in colorectal cancer

Abstract

Colorectal cancer (CRC) is one of the world's most common cancers, and has one of the highest mortality rates. The last few decades have seen great progress in preventing, diagnosing and treating this disease, providing undeniable impact on patients' prognosis and quality of life. At all these stages of CRC management, imaging techniques play an essential role. This article reviews some important issues concerning the use of various radiological techniques in the screening, diagnosis, staging, assessment of treatment response, and follow-up of patients with CRC. It also includes a number of practical recommendations on indications for use, technical requirements, minimum information required in the radiology report, evaluation criteria for the response to various drugs, and the recommended frequency at which different examinations should be performed. This consensus statement is the result of cooperation between the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Radiology (SERAM).

Consensus and controversies regarding follow‐up after treatment with curative intent of nonmetastatic colorectal cancer: a synopsis of guidelines used in countries represented in the European Society of Coloproctology

“…The intensity of the follow‐up programme was mentioned in 16 guidelines (76%) . Four of these recommended intensive follow‐up, but a uniform definition of intensive follow‐up was lacking.…”

“…The intensity of the follow‐up programme was mentioned in 16 guidelines (76%) . Four of these recommended intensive follow‐up, but a uniform definition of intensive follow‐up was lacking. In the ESMO and SEOM guidelines, this recommendation only applied to colon cancer patients and Stage II–III CRC patients, respectively.…”

“…The role of chest imaging during follow‐up of CRC patients was mentioned in all guidelines. Nineteen guidelines recommend that chest imaging should be routinely performed. The German and EURECCA guidelines stated that only rectal cancer patients should undergo routine chest imaging.…”

“…In 16 guidelines (84%) , it was recommended to use CT, whether or not alternating with X‐ray, for the detection of lung metastases. In the German , Hungarian and Russian guidelines, radiography was the preferred modality.…”

“…The use of endoscopic ultrasound in routine follow‐up was mentioned in nine (43%) of the included guidelines. Seven guidelines recommended that endoscopic ultrasound of the rectum should be part of follow‐up of selected rectal cancer patients. The guidelines listed different selection criteria for endoscopic rectal ultrasound, including: rectal cancer patients, except for pT1N0 rectal cancer patients who underwent TME ; after local excision/TEMS or Stage I rectal cancer or T1N0 rectal cancer ; T1sm2–3 and T2 rectal cancers ; rectal cancer patients with high risk (local excision of T2 or poorly differentiated tumours, those with positive margins (≤1 mm) and those with T4 or N2 rectal cancer) ; and patients who did not have an abdominoperineal excision .…”