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Phase II randomized clinical trial of endosonography and PET/CT versus clinical assessment only for follow-up after surgery for upper gastrointestinalcancer (EUFURO study) Upper gastrointestinalmalignancies have a poor prognosis. There is no consensus on how patients should be followed after surgery. The authors hypothesized that a structured follow-up programme including endoscopic ultrasonography (EUS) and [18 F]fluorodeoxyglucose (FDG) PET/CT would detect cancer recurrences, leading (...) chemotherapy (P = 0·028). Although survival after detection of recurrence in asymptomatic patients was significantly longer than that for symptomatic patients (P < 0·001), overall survival from date of surgery in the two treatment groups was comparable.Follow-up after surgery for upper gastrointestinalcancer with EUS and PET/CT leads to detection of more asymptomatic cancer recurrences and patients referred for treatment without prolonging overall survival. Registration number: NCT02209415 ( http
Colorectalcancer. Several decades ago, colorectalcancer was infrequently diagnosed. Nowadays, it is the world's fourth most deadly cancer with almost 900 000 deaths annually. Besides an ageing population and dietary habits of high-income countries, unfavourable risk factors such as obesity, lack of physical exercise, and smoking increase the risk of colorectalcancer. Advancements in pathophysiological understanding have increased the array of treatment options for local and advanced disease (...) leading to individual treatment plans. Treatments include endoscopic and surgical local excision, downstaging preoperative radiotherapy and systemic therapy, extensive surgery for locoregional and metastatic disease, local ablative therapies for metastases, and palliative chemotherapy, targeted therapy, and immunotherapy. Although these new treatment options have doubled overall survival for advanced disease to 3 years, survival is still best for those with non-metastasised disease. As the disease
Colorectalcancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy: a microsimulation modelling study. To estimate benefits and harms of different colorectalcancer screening strategies, stratified by (baseline) 15-year colorectalcancer risk.Microsimulation modelling study using MIcrosimulation SCreening ANalysis-Colon (MISCAN-Colon).A parallel guideline committee (BMJ Rapid Recommendations) defined the time frame and screening interventions, including selection (...) of outcome measures.Norwegian men and women aged 50-79 years with varying 15-year colorectalcancer risk (1-7%).Four screening strategies were compared with no screening: biennial or annual faecal immunochemical test (FIT) or single sigmoidoscopy or colonoscopy at 100% adherence.Colorectal cancer mortality and incidence, burdens, and harms over 15 years of follow-up. The certainty of the evidence was assessed using the GRADE approach.Over 15 years of follow-up, screening individuals aged 50-79 at 3% risk
Occult Blood Detection Testing for Non-ColorectalCancer Related Medical Conditions: Clinical Effectiveness Occult Blood Detection Testing for Non-ColorectalCancer Related Medical Conditions: Clinical Effectiveness | CADTH.ca Find the information you need Occult Blood Detection Testing for Non-ColorectalCancer Related Medical Conditions: Clinical Effectiveness Occult Blood Detection Testing for Non-ColorectalCancer Related Medical Conditions: Clinical Effectiveness Last updated: April 15 (...) , 2019 Project Number: RA1026-000 Product Line: Research Type: Devices and Systems Report Type: Reference List Result type: Report Question What is the clinical effectiveness of the fecal immunochemical test in detecting medical conditions other than colorectalcancer where occult blood detection is needed? What is the clinical effectiveness of the guaiac fecal blood occult test in detecting medical conditions other than colorectalcancer where occult blood detection is needed? Key Message
Strength 15 mg & 20 mg Tumour Type Gastrointestinal Indication Metastatic ColorectalCancer Funding Request Treatment of adult patients with mCRC who have been previously treated with, or are not candidates for, available therapies including fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapies, anti-VEGF biological agents, and, if RAS wild-type, anti-EGFR agents Review Status Notification to Implement Issued Pre Noc Submission No NOC Date January 25, 2018 Manufacturer Taiho Pharma Canada (...) Trifluridine and Tipiracil (Lonsurf) for Metastatic ColorectalCancer Resubmission – Details Trifluridine and Tipiracil (Lonsurf) for Metastatic ColorectalCancer Resubmission – Details | CADTH.ca Find the information you need Trifluridine and Tipiracil (Lonsurf) for Metastatic ColorectalCancer Resubmission – Details Trifluridine and Tipiracil (Lonsurf) for Metastatic ColorectalCancer Resubmission – Details Project Number pCODR 10173 Brand Name Lonsurf Generic Name Trifluridine and Tipiracil
neoplasia. ATZ: anal transitional zone. BSG: British Society of Gastroenterology. BSGM: British society of genetic medicine. CHRPE: congenital hypertrophy retinal pigmentation epithelium. CI: confidence intervals. COX-2: Cyclooxygenase-2 . CRC: colorectalcancer. CSSC: Clinical Services and Standards Committee. EHTG: European Hereditary Tumour Group. EOCRC: Early onset CRC. ESGE: European Society of Gastrointestinal Endoscopy. FAP: Familial adenomatous polyposis. FDR: First-degree relative. FH: family (...) ; Strength of recommendation: strong) o We suggest that when abdominal-perineal excision can be avoided, a standard low anterior resection is a reasonable option to treat rectal cancers in LS patients, even though the residual colon is at high-risk of metachronous neoplasia. (GRADE of evidence: low; Strength of recommendation: weak) o We recommend that gastric, small bowel, or pancreatic surveillance in LS patients is only performed in the context of a clinical trial. (GRADE of evidence: low; Strength
Breast/Ovarian Hereditary Cancer Syndromes Cancers of Unknown Primary Site Cancers of Unknown Primary Site Endocrine and Neuroendocrine Cancers Neuroendocrine Bronchial and Thymic Tumours • Neuroendocrine Gastroenteropancreatic Tumours • Adrenal Cancer • Thyroid CancerGastrointestinalCancers Rectal Cancer • Biliary cancer • Gastric cancer • Oesophageal cancer • Cancer of the pancreas • Metastatic colorectalcancer • Anal cancer • Early coloncancer • Familial risk colorectalcancer • Hepatocellular (...) carcinoma Genitourinary Cancers Testicular Germ Cell Cancer • Cancer of the Prostate • Bladder Cancer • Renal Cell Carcinoma • Penile Carcinoma • Testicular Seminoma and Non-Seminoma Gynaecological Cancers Cervical cancer • Endometrial cancer • Gestational trophoblastic disease • Newly diagnosed and relapsed epithelial ovarian carcinoma • Non-epithelial ovarian cancer • Ovarian Cancer Haematological Malignancies Waldenstrom's macroglobulinaemia • Chronic myeloid leukaemia • Newly diagnosed and relapsed
Hereditary Cancer Syndromes Cancers of Unknown Primary Site Cancers of Unknown Primary Site Endocrine and Neuroendocrine Cancers Neuroendocrine Bronchial and Thymic Tumours • Neuroendocrine Gastroenteropancreatic Tumours • Adrenal Cancer • Thyroid CancerGastrointestinalCancers Rectal Cancer • Biliary cancer • Gastric cancer • Oesophageal cancer • Cancer of the pancreas • Metastatic colorectalcancer • Anal cancer • Early coloncancer • Familial risk colorectalcancer • Hepatocellular carcinoma (...) Genitourinary Cancers Testicular Germ Cell Cancer • Cancer of the Prostate • Bladder Cancer • Renal Cell Carcinoma • Penile Carcinoma • Testicular Seminoma and Non-Seminoma Gynaecological Cancers Cervical cancer • Endometrial cancer • Gestational trophoblastic disease • Newly diagnosed and relapsed epithelial ovarian carcinoma • Non-epithelial ovarian cancer • Ovarian Cancer Haematological Malignancies Waldenstrom's macroglobulinaemia • Chronic myeloid leukaemia • Newly diagnosed and relapsed mantle cell
fruits and vegetables, fiber, and calcium). Awareness Given the data that colorectalcancer is increasing in younger individuals we must be more vigilant for signs and symptoms that could indicate a problem. I want to know if you develop blood in your stools, anemia, abdominal pain, or changes in bowel habits. However, it is also important to realize that early coloncancers and precancerous polyps do not commonly cause symptoms. 5 References American Academy of Family Physicians Statement: https (...) with a personal or family history of colorectalcancer or adenomatous polyps, persons with inflammatory boweldisease, and those with symptoms that may be attributable to colorectal. Background Recently, the American Cancer Society (ACS) released their updated 2018 ColorectalCancer (CRC) Screening Guidelines. These guidelines added the qualified recommendation* that screening for average risk patients start at 45 years of age regardless of race. Screening all adults aged 50 years and older, which
Type Gastrointestinal / Lung Indication Metastatic ColorectalCancer / Non-Small Cell Lung Cancer Biosimilar Funding Request For first-line treatment of patients with metastatic carcinoma of the colon or rectum, in combination with fluoropyrimidine based chemotherapy / For treatment of patients with unresectable advanced, metastatic or recurrent non-squamous non-small cell lung cancer, in combination with carboplatin/paclitaxel chemotherapy regimen Review Status Final Biosimilar Dossier Issued Pre (...) Mvasi for Metastatic ColorectalCancer / Non-Small Cell Lung Cancer Biosimilar – Details Mvasi for Metastatic ColorectalCancer / Non-Small Cell Lung Cancer Biosimilar – Details | CADTH.ca Find the information you need Mvasi for Metastatic ColorectalCancer / Non-Small Cell Lung Cancer Biosimilar – Details Mvasi for Metastatic ColorectalCancer / Non-Small Cell Lung Cancer Biosimilar – Details Project Number pCODR 10158 Brand Name Mvasi Generic Name Bevacizumab Strength 100 mg and 400 mg Tumour
, there is tumour penetration through the bowel wall beyond the submucosa, but there is no involvement of the regional lymph nodes or distant sites. Stage III disease involves metastases to regional lymph nodes. The overall survival (OS) of patients with stage II disease is 70% to 80% five years after surgery . More than one-third of patients with coloncarcinoma present with lymph node metastases (stage III), and more than one-half of those patients, initially treated for cure, relapse and later die (...) stage III coloncancer . Many questions remained about other therapies. In 2008, the GastrointestinalDisease Site Group (GI DSG) developed a systematic review (SR) and clinical practice guideline on adjuvant systemic chemotherapy for stage II and III coloncancer following complete resection. The guideline recommended adjuvant chemotherapy for stage III patients . For those with stage II disease, adjuvant chemotherapy was to be an option considered for the subset of patients with high-risk
words 3 | P a g e Abstract These consensus guidelines were jointly commissioned by the British Society of Gastroenterology, the Association of Coloproctology of Great Britain and Ireland and Public Health England. They provide an evidence-based framework for the use of surveillance colonoscopy and non-colonoscopic colorectal imaging in people aged 18 and over. They are the first guidelines that take into account the introduction of national bowelcancer screening. For the first time, they also (...) ); OR ? 5 or more premalignant polyps This cohort should undergo a one-off surveillance colonoscopy at 3 years. Post-CRC-resection patients should undergo a 1-year clearance colonoscopy, then a surveillance colonoscopy after 3 more years. Introduction Colorectalcancer (CRC) is a major cause of morbidity and mortality in the United Kingdom: more than 40,000 people are diagnosed and more than 16,000 people die from the disease each year.(1) The vast majority of CRCs arise from premalignant polyps
may help differentiate or further characterize the lesion. ???? X-ray abdomen 5 This procedure is a simple and inexpensive way to evaluate bowel for obstruction or constipation as the cause of the mass. ?? X-ray contrast enema 4 ??? X-ray upper GI series 4 ??? X-ray upper GI series with small bowel follow-through 4 ??? Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 2 Palpable Abdominal Mass (...) Palpable Abdominal Mass-Suspected Neoplasm. Date of origin: 1998 Last review date: 2014 ACR Appropriateness Criteria ® 1 Palpable Abdominal Mass American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Palpable Abdominal Mass Radiologic Procedure Rating Comments RRL* CT abdomen with IV contrast 9 Use of intravenous contrast may help better delineate the mass. ??? MRI abdomen without and with IV contrast 9 Use of intravenous contrast may help better delineate the mass. O
Encorafenib, Binimetinib, and Cetuximab in BRAF V600E-Mutated ColorectalCancer. Patients with metastatic colorectalcancer with the BRAF V600E mutation have a poor prognosis, with a median overall survival of 4 to 6 months after failure of initial therapy. Inhibition of BRAF alone has limited activity because of pathway reactivation through epidermal growth factor receptor signaling.In this open-label, phase 3 trial, we enrolled 665 patients with BRAF V600E-mutated metastatic colorectal (...) cancer who had had disease progression after one or two previous regimens. Patients were randomly assigned in a 1:1:1 ratio to receive encorafenib, binimetinib, and cetuximab (triplet-therapy group); encorafenib and cetuximab (doublet-therapy group); or the investigators' choice of either cetuximab and irinotecan or cetuximab and FOLFIRI (folinic acid, fluorouracil, and irinotecan) (control group). The primary end points were overall survival and objective response rate in the triplet-therapy group
Whole body MRI is effective for identifying metastatic disease in colorectalcancer patients. The studyTaylor S, Mallett S, Beare S et al. Diagnostic accuracy of whole-body MRI versus standard imaging pathways for metastatic disease in newly diagnosed colorectalcancer: the prospective Streamline C trial. Lancet Gastroenterol Hepatol 2019;4:529-37.This project was funded by the NIHR Health Technology Assessment Programme (project number 10/68/01).To read the full NIHR Signal, go to https (...) ://discover.dc.nihr.ac.uk/content/signal-000797/identifying-metastatic-disease-in-colorectal-cancer-with-whole-body-mri.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Follow-up strategies for patients treated for non-metastatic colorectalcancer. This is the fourth update of a Cochrane Review first published in 2002 and last updated in 2016.It is common clinical practice to follow patients with colorectalcancer for several years following their curative surgery or adjuvant therapy, or both. Despite this widespread practice, there is considerable controversy about how often patients should be seen, what tests should be performed, and whether these varying (...) strategies have any significant impact on patient outcomes.To assess the effect of follow-up programmes (follow-up versus no follow-up, follow-up strategies of varying intensity, and follow-up in different healthcare settings) on overall survival for patients with colorectalcancer treated with curative intent. Secondary objectives are to assess relapse-free survival, salvage surgery, interval recurrences, quality of life, and the harms and costs of surveillance and investigations.For this update, on 5
Perioperative FOLFOX 4 Versus FOLFOX 4 Plus Cetuximab Versus Immediate Surgery for High-Risk Stage II and III ColonCancers: A Phase II Multicenter Randomized Controlled Trial (PRODIGE 22) Perioperative chemotherapy has proven valuable in several tumors, but not in coloncancer (CC).The aim of this study was to evaluate the efficacy and safety of perioperative chemotherapy in patients with locally advanced nonmetastatic CC.This is a French multicenter randomized phase II trial in patients (...) with resectable high-risk T3, T4, and/or N2 CC on baseline computed tomography (CT) scan. Patients were randomized to receive either 6 months of adjuvant FOLFOX after colectomy (control) or perioperative FOLFOX for 4 cycles before surgery and 8 cycles after (FOLFOX peri-op). In RAS wild-type patients, a third arm testing perioperative FOLFOX-cetuximab was added. Tumor Regression Grade (TRG1) of Ryan et al was the primary endpoint. Secondary endpoints were toxicity, perioperative morbidity, and quality
polyposis and colorectalcancer. Nat Genet 2015; 47: 668-671. 54. Moreira L, Pellise M, Carballal S et al. High prevalence of serrated polyposis syndrome in FIT-based colorectalcancer screening programmes. Gut 2013; 62: 476-477. 55. Carballal S, Rodriguez-Alcalde D, Moreira L et al. Colorectalcancer risk factors in patients with serrated polyposis syndrome: a large multicentre study. Gut 2016; 65: 1829- 1837. 56. Bosman F, Carneiro F, Hruban R, Theise N. WHO classification of tumours of the digestive (...) of CRC (30%–73%) and extracolonic malignancies such as endometrial (30%–51%), ovarian (4%–15%), gastric (up to 18%), small bowel (3%–5%), urinary tract (2%–20%), pancreatic (4%), brain or cutaneous gland tumours [2-4]. The carriers of pathogenic variants in MLH1 and MSH2 genes have a significantly higher risk of CRC cancer with younger age at diagnosis compared with carriers of MSH6 or PMS2 pathogenic variants. The cumulative incidence of endometrial and urinary tract cancers is higher in MSH2
Multicentre randomized clinical trial of colonic J pouch or straight stapled colorectal reconstruction after low anterior resection for rectal cancerColonic J pouch reconstruction has been found to be associated with a lower incidence of anastomotic leakage than straight anastomosis. However, studies on this topic are underpowered and retrospective. This randomized trial evaluated whether the incidence of anastomotic leakage was reduced after colonic J pouch reconstruction compared (...) with straight colorectal anastomosis following anterior resection for rectal cancer.This multicentre RCT included patients with rectal carcinoma who underwent low anterior resection followed by colorectal anastomosis. Patients were assigned randomly to receive a colonic J pouch or straight colorectal anastomosis. The main outcome measure was the occurrence of major anastomotic leakage. The incidence of global (major plus minor) anastomotic leakage and general complications were secondary outcomes. Risk