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Taiwan Society of Colon and Rectal Surgeons (TSCRS) Consensus for Cytoreduction Selection in Metastatic Colorectal Cancer

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Abstract

Background

Taiwan has witnessed a surge in the incidence of colorectal cancer (CRC), of which 40–60% metastasize. Continuous updating of cytoreductive strategies in metastatic CRC (mCRC) has contributed to median overall survival reaching 40 months. In this changing scenario, to standardize the approaches across Taiwan, a group of experts from the Taiwan Society of Colon and Rectal Surgeons (TSCRS) convened to establish evidence- and opinion-based recommendations for defining the criteria of “resectability” in mCRC.

Methods

Over the course of one-on-one consultations, lasting 30–40 min each, with 30 medical specialists (19 colorectal surgeons, 4 general surgeons, and 7 medical oncologists) from 16 hospitals in Taiwan followed by a 2-h meeting with 8 physician experts (3 general surgeons, 4 colorectal surgeons, and 1 thoracic surgeon), 12 key questions on cytoreduction were addressed. This was further contextualized based on published literature.

Results

The final consensus includes eight recommendations regarding the criteria for metastasis resection, role of local control treatment in liver potentially resectable patients, management of synchronous liver metastases, approach for peritoneal metastasis, place for resection in multiple-organ metastasis, and general criteria for resectability.

Conclusions

mCRC patients undergoing R0 resection have the greatest survival advantage following surgery. Our role as a multidisciplinary team (MDT) should be to treat potentially resectable mCRC patients as rapidly and safely as possible, and achieve R0 resection as far as possible and for as long as possible (continuum of care). This TSCRS consensus statement aims to help build clinical capacity within the MDTs, while making better use of existing healthcare resources.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan

    Chun-Chi Lin MD & Jeng-Kai Jiang MD, PhD

  2. School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Chun-Chi Lin MD & Jeng-Kai Jiang MD, PhD

  3. Department of Surgery, China Medical University Hospital, Taichung, Taiwan R.O.C.

    Te-Hung Chen MD

  4. Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan

    Yu-Chung Wu MD

  5. Division of Colorectal Surgery, Department of Surgery, Chia-Yi Christian Hospital, Chia-Yi City, Taiwan

    Chuan-Yin Fang MD

  6. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Jaw-Yuan Wang MD, PhD

  7. Division of Colorectal Surgery, Taichung Veterans General Hospital, Taichung, Taiwan

    Chou-Pin Chen MD

  8. Department of Surgery and Hepatitis Research Centre, Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan

    Kai-Wen Huang MD, PhD

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Lin, CC., Chen, TH., Wu, YC. et al. Taiwan Society of Colon and Rectal Surgeons (TSCRS) Consensus for Cytoreduction Selection in Metastatic Colorectal Cancer. Ann Surg Oncol 28, 1762–1776 (2021). https://doi.org/10.1245/s10434-020-08914-8

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  • DOI: https://doi.org/10.1245/s10434-020-08914-8

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