Clinical practice guidelines for the surgical management of colon cancer: a consensus statement of the Hellenic and Cypriot Colorectal Cancer Study Group by the HeSMO

Evaghelos Xynos; Nikolaos Gouvas; Charina Triantopoulou; Paris Tekkis; Louiza Vini; Maria Tzardi; Ioannis Boukovinas; Nikolaos Androulakis; Athanasios Athanasiadis; Christos Christodoulou; Evangelia Chrysou; Christos Dervenis; Christos Emmanouilidis; Panagiotis Georgiou; Ourania Katopodi; Panteleimon Kountourakis; Thomas Makatsoris; Pavlos Papakostas; Demetris Papamichael; Georgios Pentheroudakis; Ioannis Pilpilidis; Joseph Sgouros; Vassilios Vassiliou; Spyridon Xynogalos; Nikolaos Ziras; Niki Karachaliou; Odysseas Zoras; Christos Agalianos; John Souglakos

Authors Evaghelos Xynos, Nikolaos Gouvas, Charina Triantopoulou, Paris Tekkis, Louiza Vini, Maria Tzardi, Ioannis Boukovinas, Nikolaos Androulakis, Athanasios Athanasiadis, Christos Christodoulou, Evangelia Chrysou, Christos Dervenis, Christos Emmanouilidis, Panagiotis Georgiou, Ourania Katopodi, Panteleimon Kountourakis, Thomas Makatsoris, Pavlos Papakostas, Demetris Papamichael, Georgios Pentheroudakis, Ioannis Pilpilidis, Joseph Sgouros, Vassilios Vassiliou, Spyridon Xynogalos, Nikolaos Ziras, Niki Karachaliou, Odysseas Zoras, Christos Agalianos, John Souglakos.

Abstract

Despite considerable improvement in the management of colon cancer, there is a great deal of variation in the outcomes among European countries, and in particular among diff erent hospital centers in Greece and Cyprus. Discrepancy in the approach strategies and lack of adherence to guidelines for the management of colon cancer may explain the situation. Th e aim was to elaborate a consensus on theÂ multidisciplinary management of colon cancer, based on European guidelines (ESMO and EURECCA), and also taking into account local special characteristics of our healthcare system. Following discussion and online communication among members of an executive team, a consensus was developed. Statements entered the Delphi voting system on two rounds to achieve consensus by multidisciplinary international experts. Statements with an agreement rate of â‰¥80% achieved a large consensus, while those with an agreement rate of 60-80% a moderate consensus. Statements achieving an agreement of <60% aft er both rounds were rejected and not presented. Sixty statements on the management of colon cancer were subjected to the Delphi methodology. Voting experts were 109. Th e median rate of abstain per statement was 10% (range: 0-41%). In the end of the voting process, all statements achieved a consensus by more than 80% of the experts. A consensus on the management of colon cancer was developed by applying the Delphi methodology. Guidelines are proposed along with algorithms of diagnosis and treatment. Th e importance of centralization, care by a multidisciplinary team, and adherence to guidelines is emphasized.

Keywords Colon cancer, surgery, guidelines

Ann Gastroenterol 2016; 29 (1): 3-17