Chen Hong-Hwa, Ke Tao-Wei, Huang Ching-Wen, Jiang Jeng-Kae, Chen Chou-Chen, Hsieh Yao-Yu, Teng Hao-Wei, Lin Bo-Wen, Liang Yi-Hsin, Su Yu-Li, Hsu Hung-Chih, Kuan Feng-Che, Chou Yenn-Hwei, Lin Johnson, Lin Ben-Ren, Chang Yu-Yao, Wang Jaw-Yuan
Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Department of Colorectal Surgery, China Medical University Hospital, Taichung, Taiwan.
Front Oncol. 2021 Nov 15;11:764912. doi: 10.3389/fonc.2021.764912. eCollection 2021.
Therapeutic options for metastatic CRC (mCRC) have changed significantly in recent years, greatly increasing the complexity of therapeutic decision-making. Although oncology guidelines have helped improve the care process, guidelines may also limit the flexibility to individualize in-clinic decision-making. This consensus paper addresses specific gaps in the current international guidelines to assist Taiwanese colon and rectal experts make specific therapeutic choices. Over 3 years and three meetings with selected experts on "real-world" Taiwanese practice patterns for mCRC, consensus was achieved. The experts also discussed specific questions during in-depth one-on-one consultation. Outcomes of the discussion were then correlated with published evidence by an independent medical writer. The final consensus includes clinically implementable recommendations to provide guidance in treating Taiwanese mCRC patients. The consensus includes criteria for defining fit and unfit intensive treatment patients, treatment goals, treatment considerations of molecular profiles, treatment consideration, and optimal treatment choices between different patient archetypes, including optimal treatment options based on , , and microsatellite instability (MSI) status. This consensus paper is the second in the Taiwan Society of Colon and Rectal Surgeons (TSCRS) Consensus series to address unmet gaps in guideline recommendations in lieu of Taiwanese mCRC management. Meticulous discussions with experts, the multidisciplinary nature of the working group, and the final drafting of the consensus by independent medical professionals have contributed to the strong scientific value of this consensus.
近年来，转移性结直肠癌（mCRC）的治疗选择发生了显著变化，极大地增加了治疗决策的复杂性。尽管肿瘤学指南有助于改善治疗过程，但指南也可能限制临床决策个体化的灵活性。本共识文件旨在解决当前国际指南中的特定差距，以协助台湾的结肠和直肠专家做出具体的治疗选择。经过三年时间以及与选定的专家就台湾mCRC“真实世界”实践模式进行的三次会议，达成了共识。专家们还在深入的一对一咨询中讨论了具体问题。随后，独立医学撰写人将讨论结果与已发表的证据进行了关联。最终共识包括可在临床上实施的建议，为治疗台湾mCRC患者提供指导。该共识包括定义适合和不适合强化治疗患者的标准、治疗目标、分子特征的治疗考量、治疗考虑因素以及不同患者原型之间的最佳治疗选择，包括基于 、 以及微卫星不稳定性（MSI）状态的最佳治疗方案。本共识文件是台湾结肠直肠外科医师学会（TSCRS）共识系列中的第二篇，旨在解决指南建议中未满足的差距，以取代台湾mCRC的管理。与专家的细致讨论、工作组的多学科性质以及独立医学专业人员对共识的最终起草，都为这一共识的强大科学价值做出了贡献。
