EURECCA consensus conference highlights about colon & rectal cancer multidisciplinary management: the radiology experts review.
Some interesting shifts have taken place in the diagnostic approach for detection of colorectal lesions over the past decade. This article accompanies the recent EURECCA consensus group reccomendations for optimal management of colon and rectal cancers. In summary, imaging has a crucial role to play in the diagnosis, staging assessment and follow up of patients with colon and rectal cancer. Recent advances include the use of CT colonography instead of Barium Enema in the diagnosis of colonoic cancer and as an alternative to colonoscopy. Modern mutlidetector CT scanning techniques have also shown improvements in prognostic stratification of patients with colonic cancer and clinical trials are underway testing the selective use of neoadjuvant therapy for imaging identified high risk colon cancers. In rectal cancer, high resolution MRI with a voxel size less or equal to 3 × 1 × 1 mm3 on T2-weighted images has a proven ability to accurately stage patients with rectal cancer. Moreover, preoperative identification of prognostic features allows stratification of patients into different prognostic groups based on assessment of depth of extramural spread, relationship of the tumour edge to the mesorectal fascia (MRF) and extramural venous invasion (EMVI). These poor prognostic features predict an increased risk of local recurrence and/or metastatic disease and should form the basis for preoperative local staging and multidisciplinary preoperative discussion of patient treatment options.
Department of Radiology, The Royal Marsden NHS Foundation Trust, Fulham Road, London, UK.
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Tudyka
European Society of Radiology, Department of Diagnostic Radiology, Karolinska University Hospital, Stockholm, Sweden.
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Blomqvist
European Society of Radiology, Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.
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Beets-Tan
Scientific Board CC3, Department of Surgery, Leiden University Medical Center, The Netherlands. Electronic address: P.G.Boelens@lumc.nl.
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Boelens
Executive Committee CC3, European Society for Radiotherapy and Oncology (ESTRO), Department of Radiation Oncology, Università Cattolica S. Cuore, Rome, Italy.
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Valentini
Executive Board of ECCO, European Society of Surgical Oncology (ESSO), Department of Surgery, Leiden University Medical center, The Netherlands.
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van de Velde
Diagnóstico Médico, Junín 1023, Ciudad Autónoma de Buenos Aires, Argentina.
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Dieguez
Department of Radiology, The Royal Marsden NHS Foundation Trust, Fulham Road, London, UK. Electronic address: gina.brown@rmh.nhs.uk.
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Brown
D000465:Algorithms; D001706:Biopsy; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000517:prevention & control; D005060:Europe; D006801:Humans; D033183:Interdisciplinary Communication; D007415:Intestinal Obstruction / Q000209:etiology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D061330:Multidetector Computed Tomography; D020360:Neoadjuvant Therapy / Q000379:methods*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011379:Prognosis
Colon cancer; Consensus; Guidelines; Rectal cancer