ASCO issues guidelines for early CRC

  • Costas-Chavarri A & al.
  • J Glob Oncol
  • 1 Feb 2019

  • Oncology guidelines update
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  • The American Society of Clinical Oncology (ASCO) has released recommendations for the treatment of early-stage colorectal cancer (CRC) based on a systematic review of 12 existing guidelines.

Why this matters

  • New guidelines provide recommendations for different resource settings.

Key points

  • Stage I-III colon cancer optimal treatment:
    • Most patients are treated with surgery, either laparoscopic or open resection along with draining nodal stages.
    • Postsurgical chemotherapy, when available, is an option for patients with stage III tumors and high-risk stage II tumors.
    • Adjuvant chemotherapy should be used in cases of high-risk obstructing colon cancer.
  • Stage I-III rectal cancer treatment:
    • The primary mode of treatment is surgery, with the specific procedure depending on the resource-level setting.
    • Chemotherapy and/or radiotherapy is recommended, based on availability and potential risk factors, for patients with clinically resectable cT3N0 rectal cancer, high-risk stage II rectal cancer, and all patients with stage III rectal cancer. Preoperative risk factors should determine use of neoadjuvant therapy.
  • Posttreatment surveillance for CRC:  
    • Follow-up should include medical history, physical examinations, carcinoembryonic antigen testing, imaging, and surveillance endoscopy. The follow-up frequency and other details depend on cancer stage and resource setting.
  • Additional data, including evidence tables, is available online.

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