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结直肠腹膜转移的诊断和治疗算法。意大利肿瘤外科学会腹膜表面恶性肿瘤肿瘤团队的共识。

Diagnostic and therapeutic algorithm for colorectal peritoneal metastases. A consensus of the peritoneal surface malignancies onco-team of the Italian society of surgical oncology.

机构信息

Unit of Surgical Oncology of the Esophagus and Digestive Tract, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.

Unit of General and Emergency Surgery, Bufalini Hospital, Cesena, Italy.

出版信息

Eur J Surg Oncol. 2021 Jan;47(1):164-171. doi: 10.1016/j.ejso.2020.09.035. Epub 2020 Sep 29.

Abstract

AIM

the surgical workup for colorectal cancer peritoneal metastases (CRCPM) is complex and should be managed in specialized centers. Diagnostic and therapeutic algorithms (DTA) have been proposed to balance optimal patients management and correct use of resources. Aim of this study was to establish a consensus on DTA for CRCPM patients in Italy.

METHOD

a panel of 18 delegated members of centers afferent to Peritoneal Surface Malignancies Onco-team of the Italian Society of Surgical Oncology was established. A list of statements regarding the DTA of patients with CRCPM was prepared according to different activities and decision-making nodes with a defined entry and exit point. Consensus was obtained through RAND UCLA methodology.

RESULTS

two different DTA were defined and approved according to the modality of presentation of CRCPM (synchronous and metachronous). A consensus was also obtained on 17 of the 19 statements related to DTA.

CONCLUSION

a shared model of DTA is now available for healthcare providers to monitor appropriateness in diagnosis and treatment of patients with isolated peritoneal metastases from CRC.

摘要

目的

结直肠癌腹膜转移(CRCPM)的外科评估较为复杂,应在专门的中心进行管理。已经提出了诊断和治疗算法(DTA),以平衡最佳的患者管理和正确使用资源。本研究的目的是在意大利就 CRCPM 患者的 DTA 达成共识。

方法

成立了一个由意大利外科肿瘤学会腹膜表面恶性肿瘤肿瘤团队附属中心的 18 名代表成员组成的专家组。根据不同的活动和决策节点,列出了一份关于 CRCPM 患者 DTA 的陈述清单,明确了进入和退出的节点。通过 RAND UCLA 方法获得共识。

结果

根据 CRCPM 的表现方式(同步和异时),确定并批准了两种不同的 DTA。还就与 DTA 相关的 19 项声明中的 17 项达成了共识。

结论

为了监测 CRC 孤立性腹膜转移患者的诊断和治疗的适宜性,现在为医疗保健提供者提供了一个共享的 DTA 模型。

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