1
|
Aytaç E, Özer L, Baca B, Balık E, Kapran Y, Cığ Taşkın O, Uluç BO, Ufuk Abacıoğlu M, Gönenç M, Bölükbaşı Y, Çil BE, Baran B, Aygün C, Erdem Yıldız M, Ünal K, Erkol B, Yaltı T, Özbek U, Attila T, Tözün N, Gürses B, Erdamar S, Er Ö, Beşe N, Bilge O, Onur Ceyhan G, Molinas Mandel N, Selek U, Yakıcıer C, Kayserili Karabey H, Saruç M, Özben V, Esen E, Özoran E, Vardareli E, Güner L, Hamzaoğlu İ, Buğra D, Karahasanoğlu T, İstanbul Group T. Optimizing the Personalized Care for the Management of Rectal Cancer: A Consensus Statement. Turk J Gastroenterol 2022; 33:627-663. [PMID: 35993526 PMCID: PMC9524446 DOI: 10.5152/tjg.2022.211103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Colorectal cancer is the third most common cancer in Turkey. The current guidelines do not provide sufficient information to cover all aspects of the management of rectal cancer. Although treatment has been standardized in terms of the basic principles of neoadjuvant, surgical, and adjuvant therapy, uncertainties in the management of rectal cancer may lead to significant differences in clinical practice. In order to clarify these uncertainties, a consensus program was constructed with the participation of the physicians from the Acıbadem Mehmet Ali Aydınlar and Koç Universities. This program included the physicians from the departments of general surgery, gastroenterology, pathology, radiology, nuclear medicine, medical oncology, radiation oncology, and medical genetics. The gray zones in the management of rectal cancer were determined by reviewing the evidence-based data and current guidelines before the meeting. Topics to be discussed consisted of diagnosis, staging, surgical treatment for the primary disease, use of neoadjuvant and adjuvant treatment, management of recurrent disease, screening, follow-up, and genetic counseling. All those topics were discussed under supervision of a presenter and a chair with active participation of related physicians. The consensus text was structured by centralizing the decisions based on the existing data.
Collapse
Affiliation(s)
- Erman Aytaç
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Leyla Özer
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Bilgi Baca
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Emre Balık
- Koç University Faculty of Medicine, İstanbul, Turkey
| | - Yersu Kapran
- Koç University Faculty of Medicine, İstanbul, Turkey
| | | | - Başak Oyan Uluç
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | | | - Murat Gönenç
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | | | | | - Bülent Baran
- Koç University Faculty of Medicine, İstanbul, Turkey
| | - Cem Aygün
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Mehmet Erdem Yıldız
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Kemal Ünal
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Burçak Erkol
- Koç University Faculty of Medicine, İstanbul, Turkey
| | - Tunç Yaltı
- Koç University Faculty of Medicine, İstanbul, Turkey
| | - Uğur Özbek
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Tan Attila
- Koç University Faculty of Medicine, İstanbul, Turkey
| | - Nurdan Tözün
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Bengi Gürses
- Koç University Faculty of Medicine, İstanbul, Turkey
| | - Sibel Erdamar
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Özlem Er
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
- Corresponding author: Erman Aytaç, e-mail:
| | - Nuran Beşe
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Orhan Bilge
- Koç University Faculty of Medicine, İstanbul, Turkey
| | - Güralp Onur Ceyhan
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | | | - Uğur Selek
- Koç University Faculty of Medicine, İstanbul, Turkey
| | - Cengiz Yakıcıer
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | | | - Murat Saruç
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Volkan Özben
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Eren Esen
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Emre Özoran
- Koç University Faculty of Medicine, İstanbul, Turkey
| | - Erkan Vardareli
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Levent Güner
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - İsmail Hamzaoğlu
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| | - Dursun Buğra
- Koç University Faculty of Medicine, İstanbul, Turkey
| | | | - The İstanbul Group
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
| |
Collapse
|
2
|
Aytaç E, Aslan F, Çicek B, Erdamar S, Gürses B, Güven K, Falay O, Karahasanoğlu T, Selçukbiricik F, Selek U, Atalar B, Balık E, Tözün N, Rozanes İ, Arıcan A, Hamzaoğlu İ, Baca B, Molinas Mandel N, Saruç M, Göksel S, Demir G, Ağaoğlu F, Yakıcıer C, Özbek U, Özben V, Özyar E, Güner AL, Er Ö, Kaban K, Bölükbaşı Y, Buğra D, Group Tİ. Dealing with the gray zones in the management of gastric cancer: The consensus statement of the İstanbul Group. Turk J Gastroenterol 2020; 30:584-598. [PMID: 30541724 DOI: 10.5152/tjg.2018.18737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The geographical location and differences in tumor biology significantly change the management of gastric cancer. The prevalence of gastric cancer ranks fifth and sixth among men and women, respectively, in Turkey. The international guidelines from the Eastern and Western countries fail to manage a considerable amount of inconclusive issues in the management of gastric cancer. The uncertainties lead to significant heterogeneities in clinical practice, lack of homogeneous data collection, and subsequently, diverse outcomes. The physicians who are professionally involved in the management of gastric cancer at two institutions in Istanbul, Turkey, organized a consensus meeting to address current problems and plan feasible, logical, measurable, and collective solutions in their clinical practice for this challenging disease. The evidence-based data and current guidelines were reviewed. The gray zones in the management of gastric cancer were determined in the first session of this consensus meeting. The second session was constructed to discuss, vote, and ratify the ultimate decisions. The identification of the T stage, the esophagogastric area, imaging algorithm for proper staging and follow-up, timing and patient selection for neoadjuvant treatment, and management of advanced and metastatic disease have been accepted as the major issues in the management of gastric cancer. The recommendations are presented with the percentage of supporting votes in the results section with related data.
Collapse
Affiliation(s)
- Erman Aytaç
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Fatih Aslan
- Koç University School of Medicine, İstanbul, Turkey
| | - Bahattin Çicek
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Sibel Erdamar
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Bengi Gürses
- Koç University School of Medicine, İstanbul, Turkey
| | - Koray Güven
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Okan Falay
- Koç University School of Medicine, İstanbul, Turkey
| | | | | | - Uğur Selek
- Koç University School of Medicine, İstanbul, Turkey
| | - Banu Atalar
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Emre Balık
- Koç University School of Medicine, İstanbul, Turkey
| | - Nurdan Tözün
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | | | - Ali Arıcan
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - İsmail Hamzaoğlu
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Bilgi Baca
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | | | - Murat Saruç
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Süha Göksel
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Gökhan Demir
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Fulya Ağaoğlu
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Cengiz Yakıcıer
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Uğur Özbek
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Volkan Özben
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Enis Özyar
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Ahmet Levent Güner
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Özlem Er
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Kerim Kaban
- Koç University School of Medicine, İstanbul, Turkey
| | - Yasemin Bölükbaşı
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Dursun Buğra
- Koç University School of Medicine, İstanbul, Turkey
| | - The İstanbul Group
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| |
Collapse
|