Clinical practice guidelines for the management of metastatic colorectal cancer: a consensus statement of the Hellenic Society of Medical Oncologists (HeSMO)

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

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

Abstract

There is discrepancy and failure to adhere to current international guidelines for the management of metastatic colorectal cancer (CRC) in hospitals in Greece and Cyprus. The aim of the present document is to provide a consensus on the multidisciplinary management of metastastic CRC, considering both special characteristics of our Healthcare System and international guidelines. Following discussion and online communication among the members of an executive team chosen by the Hellenic Society of Medical Oncology (HeSMO), a consensus for metastastic CRC disease was developed. Statements were subjected to the Delphi methodology on two voting rounds by invited multidisciplinary international experts on CRC. Statements reaching level of agreement by â‰¥80% were considered as having achieved large consensus, whereas statements reaching 60-80% moderate consensus. One hundred and nine statements were developed. Ninety experts voted for those statements. The median rate of abstain per statement was 18.5% (range: 0-54%). In the end of the process, all statements achieved a large consensus. The importance of centralization, care by a multidisciplinary team, adherence to guidelines, and personalization is emphasized. R0 resection is the only intervention that may offer substantial improvement in the oncological outcomes.

Keywords Colorectal cancer, metastatic disease, surgery, guidelines

Ann Gastroenterol 2016; 29 (4): 390-416