title: EURECCA colorectal: multidisciplinary mission statement on better care for patients with colon and rectal cancer in Europe.
abstract: BACKGROUND
  Care for patients with colon and rectal cancer has improved in the last twenty years however still considerable variation exists in cancer management and outcome between European countries. Therefore, EURECCA, which is the acronym of European Registration of cancer care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012 the first multidisciplinary consensus conference about colon and rectum was held looking for multidisciplinary consensus. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries.
  
  
  METHODS
  The expert panel had delegates of the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy & Oncology (ESTRO), European Society of Pathology (ESP), European Society for Medical Oncology (ESMO), European Society of Radiology (ESR), European Society of Coloproctology (ESCP), European CanCer Organisation (ECCO), European Oncology Nursing Society (EONS) and the European Colorectal Cancer Patient Organisation (EuropaColon), as well as delegates from national registries or audits. Experts commented and voted on the two web-based online voting rounds before the meeting (between 4th and 25th October and between the 20th November and 3rd December 2012) as well as one online round after the meeting (4th-20th March 2013) and were invited to lecture on the subjects during the meeting (13th-15th December 2012). The sentences in the consensus document were available during the meeting and a televoting round during the conference by all participants was performed. All sentences that were voted on are available on the EURECCA website www.canceraudit.eu. The consensus document was divided in sections describing evidence based algorithms of diagnostics, pathology, surgery, medical oncology, radiotherapy, and follow-up where applicable for treatment of colon cancer, rectal cancer and stage IV separately. Consensus was achieved using the Delphi method.
  
  
  RESULTS
  The total number of the voted sentences was 465. All chapters were voted on by at least 75% of the experts. Of the 465 sentences, 84% achieved large consensus, 6% achieved moderate consensus, and 7% resulted in minimum consensus. Only 3% was disagreed by more than 50% of the members.
  
  
  CONCLUSIONS
  It is feasible to achieve European Consensus on key diagnostic and treatment issues using the Delphi method. This consensus embodies the expertise of professionals from all disciplines involved in the care for patients with colon and rectal cancer. Diagnostic and treatment algorithms were developed to implement the current evidence and to define core treatment guidance for multidisciplinary team management of colon and rectal cancer throughout Europe.
authors.affiliation: EURECCA and CC3, Executive Board of ECCO, Department of Surgery, Leiden University Medical Center, The Netherlands. c.j.h.van_de_velde@lumc.nl
authors.forename: Cornelis J H
authors.initials: CJ
authors.lastname: van de Velde
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authors.lastname: Boelens
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authors.lastname: Beets-Tan
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authors.lastname: Blomqvist
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authors.lastname: van den Broek
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authors.lastname: Brown
authors.forename: Jan-Willem
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authors.lastname: Coebergh
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authors.lastname: Gore-Booth
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authors.forename: Lene H
authors.initials: LH
authors.lastname: Iversen
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authors.lastname: Han van Krieken
authors.forename: Corrie A M
authors.initials: CA
authors.lastname: Marijnen
authors.forename: Pawel
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authors.lastname: Mroczkowski
authors.forename: Iris
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authors.lastname: Nagtegaal
authors.forename: Peter
authors.initials: P
authors.lastname: Naredi
authors.forename: Hector
authors.initials: H
authors.lastname: Ortiz
authors.forename: Lars
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authors.lastname: Påhlman
authors.forename: Philip
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authors.lastname: Quirke
authors.forename: Claus
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authors.lastname: Rödel
authors.forename: Arnaud
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authors.lastname: Roth
authors.forename: Harm J T
authors.initials: HJ
authors.lastname: Rutten
authors.forename: Hans J
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authors.lastname: Schmoll
authors.forename: Jason
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authors.lastname: Smith
authors.forename: Pieter J
authors.initials: PJ
authors.lastname: Tanis
authors.forename: Claire
authors.initials: C
authors.lastname: Taylor
authors.forename: Arne
authors.initials: A
authors.lastname: Wibe
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Gambacorta
authors.forename: Elisa
authors.initials: E
authors.lastname: Meldolesi
authors.forename: Theo
authors.initials: T
authors.lastname: Wiggers
authors.forename: Andres
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authors.lastname: Cervantes
authors.forename: Vincenzo
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mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000628:therapy*; D032921:Consensus; D003299:Cooperative Behavior; D003697:Delphi Technique; D005060:Europe; D019983:Guideline Adherence; D006801:Humans; D033183:Interdisciplinary Communication; D010348:Patient Care Team / Q000592:standards; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*; D016896:Treatment Outcome
keywords: Audit; Colon cancer; Consensus; Delphi method; Minimal invasive surgery; Multidisciplinary team; Neoadjuvant chemoradiotherapy; Neoadjuvant radiotherapy; Quality assurance; Rectal cancer