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References 1. Best L, Simmonds P, Baughan C, et al. Palliative chemotherapy for advanced or metastatic colorectal cancer. The Cochrane Library. 3. Chichester, UK: John Wiley and Sons, Ltd, 2004. 2. Saltz LB, Cox JV, Blanke C, et al. Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 2000; 343: 905–14. 3. Douillard JY, Cunningham D, Roth AD, et al. Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet 2000; 355: 1041–7. 4. Cunningham D, Pyrhonen S, James RD, et al. Randomised trial of irinotecan plus supportive care versus supportive care alone after fluorouracil failure for patients with metastatic colorectal cancer. Lancet 1998; 352: 1413–8. 5. Rougier P, Van Cutsem E, Bajetta E, et al. Randomised trial of irinotecan versus fluorouracil by continuous infusion after fluorouracil failure in patients with metastatic colorectal cancer. Lancet 1998; 352: 1407–12. 6. Nordic Gastrointestinal Tumor Adjuvant Therapy Group. Expectancy or primary chemotherapy in patients with advanced asymptomatic colorectal cancer: a randomized trial. J Clin Oncol 1992; 10: 904–11. 7. Ackland S, Moore M, Jones M, et al. A meta-analysis of two randomized trials of early chemotherapy in asymptomatic metastatic colorectal cancer. Proc Am Soc Clin Oncol 2001; Abstract 526. 8. Thirion P, Michiels S, Pignon JP, et al. Modulation of fluorouracil by leucovorin in patients with advanced colorectal cancer: an updated meta-analysis. J Clin Oncol 2004; 22: 3766–75. 9. Buroker TR, O’Connell MJ, Wieand HS, et al. Randomized comparison of two schedules of fluorouracil and leucovorin in the treatment of advanced colorectal cancer. J Clin Oncol 1994; 12: 14–20. 10. Poon MA, O’Connell MJ, Wieand HS, et al. Biochemical modulation of fluorouracil with leucovorin: confirmatory evidence of improved therapeutic efficacy in advanced colorectal cancer. J Clin Oncol 1991; 9: 1967–72. 11. Labianca R, Cascinu S, Frontini L, et al. High- versus low-dose levo-leucovorin as a modulator of 5-fluorouracil in advanced colorectal cancer: a ‘GISCAD’ phase III study. Italian Group for the Study of Digestive Tract Cancer. Ann Oncol 1997; 8: 169–74. 12. Petrelli N, Douglass HO, Jr., Herrera L, et al. The modulation of fluorouracil with leucovorin in metastatic colorectal carcinoma: a prospective randomized phase III trial. Gastrointestinal Tumor Study Group. J Clin Oncol 1989; 7: 1419–26. 13. Jager E, Heike M, Bernhard H, et al. Weekly high-dose leucovorin versus low-dose leucovorin combined with fluorouracil in advanced colorectal cancer: results of a randomized multicenter trial. Study Group for Palliative Treatment of Metastatic Colorectal Cancer Study Protocol 1. J Clin Oncol 1996; 14: 2274–9. 14. Wang WS, Lin JK, Chiou TJ, et al. Randomized trial comparing weekly bolus 5-fluorouracil plus leucovorin versus monthly 5-day 5-fluorouracil plus leucovorin in metastatic colorectal cancer. Hepatogastroenterology 2000; 47: 1599–603. The role of systemic chemotherapy in metastatic disease 227
15. Meta-analysis Group in Cancer. Efficacy of intravenous continuous infusion of fluorouracil compared with bolus administration in advanced colorectal cancer. J Clin Oncol 1998; 16: 301–8. 16. de Gramont A, Bosset JF, Milan C, et al. Randomized trial comparing monthly low-dose leucovorin and fluorouracil bolus with bimonthly high-dose leucovorin and fluorouracil bolus plus continuous infusion for advanced colorectal cancer: a French intergroup study. J Clin Oncol 1997; 15: 808–15. 17. Malet-Martino M, Martino R. Clinical studies of three oral prodrugs of 5-Fluorouracil (Capecitabine, UFT, S-1): A review. The Oncologist 2002; 7: 299–323. 18. Liu G, Franssen E, Fitch MI, Warner E. Patient preferences for oral versus intravenous palliative chemotherapy. J Clin Oncol 1997; 15: 110–5. 19. McGavin JK, Goa KL. Capecitabine: a review of its use in the treatment of advanced or metastatic colorectal cancer. Drugs 2001; 61: 2309–26. 20. Douillard JY, Hoff PM, Skillings JR, et al. Multicentre phase III study of uracil/tegafur and oral leucovorin versus parenteral flourouracil and leucovorin in patients with previously untreated metastatic colorectal cancer. Journal of Clinical Oncology 2002; 20: 3605–16. 21. Carmichael J, Popiela T, Radstone D, et al. Randomized comparative study of tegafur/uracil and oral leucovorin versus parenteral fluorouracil and leucovorin in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 2002; 20: 3617–27. 22. Cunningham D, Zalcberg J, Maroun J, et al. Efficacy, tolerability and management of raltitrexed (Tomudex) monotherapy in patients with advanced colorectal cancer. a review of phase II/III trials. Eur J Cancer 2002; 38: 478–86. 23. Maughan TS, James RD, Kerr DJ, et al. Comparison of survival, palliation, and quality of life with three chemotherapy regimens in metastatic colorectal cancer: a multicentre randomised trial. Lancet 2002; 359: 1555–63. 24. Khayat D, Gil-Delgado M, Antoine EC, Nizri D, Bastian G. The role of irinotecan and oxaliplatin in the treatment of advanced colorectal cancer. Oncology (Huntingt) 2001; 15: 415–29. 25. de Gramont A, Figer A, Seymour M, et al. Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 2000; 18: 2938– 47. 26. Giacchetti S, Perpoint B, Zidani R, et al. Phase III multicenter randomized trial of oxaliplatin added to chronomodulated fluorouracil-leucovorin as first-line treatment of metastatic colorectal cancer. J Clin Oncol 2000; 18: 136–47. 27. Tournigand C, Andre T, Achille E, et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 2004; 22: 229–37. 28. Goldberg RM, Sargent DJ, Morton RF, et al. A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 2004; 22: 23–30. 29. Raymond E, Boige V, Faivre S, et al. Dosage adjustment and pharmacokinetic profile of irinotecan in cancer patients with hepatic dysfunction. J Clin Oncol 2002; 20: 4303–12. 228 The prevention, early detection and management of colorectal cancer
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Clinical Practice Guidelines FOR TH
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© The Cancer Council Australia/Aus
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2.11 Conclusions...................
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11.2 High ligation ................
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17.4 Cost effectiveness of follow u
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Table 14.3 Pathological TNM staging
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Executive Summary • Colorectal Ca
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STRENGTH OF RECOMMENDATIONS 2,3 The
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Should red meat intake be altered t
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Chapter Recommendations 4 COMMUNICA
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Chapter 8 Recommendations How shoul
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Chapter Recommendations Should bowe
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Chapter Recommendations When should
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Chapter 17 Recommendations What pos
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Section I Early Colorectal Cancer
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Adenomatous polyps (adenomas) are b
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17. South Australian Cancer Registr
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CHAPTER 2 PRIMARY PREVENTION Studie
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Colorectal adenomas, especially adv
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vegetable (3.5 serves/1000 kcals) d
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mustard greens, swedes and turnips)
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for protection against Colorectal C
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Does selenium supplementation reduc
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the optimal duration of use, and ad
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References 1. Jass JR. Pathogenesis
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34. Kushi L, Giovannucci E. Dietary
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67. Fearon ER, Vogelstein B. A gene
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100. Il'yasova D, Hodgson ME, Marti
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133. Meyskens FL, Jr., Gerner EW. D
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CHAPTER 3 POPULATION SCREENING FOR
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studies also demonstrate that age i
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• symptoms • family medical his
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Should screening be recommended? Gu
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Box 3.3 Screening Pathway used in t
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References 1. Young GP, Levin B, Ro
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33. Alexander F, Weller D. Evaluati
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CHAPTER 4 COMMUNICATION WITH THE PA
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4.6 Coordination of care Treatment
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• assistance with and care of chi
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17. National Breast Cancer Centre,
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CHAPTER 5 THE PATIENT WITH SYMPTOMS
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considered (see 8.1.5). Double cont
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58 The prevention, early detection
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diagnoses prove difficult to confir
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What recommendations are there for
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References 1. Woolf CM. A genetic s
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34. Australian Health Technology Ad
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CHAPTER 7 HIGH-RISK FAMILIAL COLORE
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offered predictive genetic testing.
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endoscopically uncontrollable numbe
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mutation carriers. 52 There is also
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standard for consideration of MSI a
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added to transvaginal ultrasound. 8
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category 2, see Chapter 6) but may
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What screening is recommended for e
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References 1. Vasen HF, Griffioen G
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33. Giardiello FM, Hamilton SR, Kru
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international criteria for the dete
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96. Burt RW, Jass JR. Hyperplastic
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8.1.2 Sigmoidoscopy: rigid versus f
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For radiological imaging of the lar
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8.2.3 Staging for distant metastase
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The feelings and fears of the patie
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18. Rex DK, Cutler CS, Lemmel GT et
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52. Liu SK, Church JM, Lavery IC, F
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strong family history of Colorectal
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A screening interval of 4-6 years i
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BRAF mutation, particularly when mu
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18. Jass JR, Young J, Leggett BA. E
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52. Jass JR, Young J, Leggett BA. H
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What is the role of the stomal ther
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What happens if a blood transfusion
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References 1. Bass EM, Del Pino A,
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32. The National Working Party on t
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CHAPTER 11 ELECTIVE SURGERY FOR COL
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Total or subtotal colectomy may be
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11.12 Self-expanding metal stents f
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18. Gall FP, Tonak J, Altendorf A.
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etween 1993 and 1999. The local rec
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When should local excision of recta
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What factors influence sphincter pr
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It has been demonstrated that there
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References 1. Smith TJ, Hillner BE,
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36. Vernava AM, III, Moran M, Rothe
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69. Pimentel JM, Duarte A, Gregorio
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A clinical diagnosis of large bowel
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When should primary anastomosis be
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17. Deans GT, Krukowski ZH, Irwin S
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Table 14.1 Clinicopathological stag
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The ACPS system embodies the simpli
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14.4 Translation between staging sy
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16. Shepherd NA, Baxter KJ, Love SB
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CHAPTER 15 ADJUVANT CHEMOTHERAPY FO
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isk of death-favouring treatment (H
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improvement in survival at five yea
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Page 209 and 210: References 1. National Institute of
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Page 213 and 214: 57. Gastrointestinal Tumour Study G
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Page 217 and 218: preoperative RT 45Gy over 5 weeks s
Page 219 and 220: This suggests that a policy of preo
Page 221 and 222: Mortality from non-cancer causes wa
Page 223 and 224: References 1. Fu KK. Interactions o
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Page 227 and 228: 198 The prevention, early detection
Page 229 and 230: Rates of intraluminal recurrence an
Page 231 and 232: Ultrasonographic screening Ultrason
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Page 237 and 238: • those with a history of psychia
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Page 244 and 245: CHAPTER 19 RECURRENT AND ADVANCED C
Page 246 and 247: What are the recommendations for in
Page 248 and 249: References 1. National Health and M
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Page 252 and 253: Recurrent and advanced colorectal c
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Page 256 and 257: more patients having disease down-s
Page 260 and 261: 30. Fuchs CS, Moore MR, Harker G, V
Page 262 and 263: CHAPTER 21 MANAGEMENT OF LIVER AND
Page 264 and 265: 21.1.3 Imaging controlled destructi
Page 266 and 267: Does combination systemic chemother
Page 268 and 269: References 1. Woodington FF, Waugh
Page 270 and 271: 34. Wood BJ, Ramkaransingh JR, Fojo
Page 272 and 273: 66. Headrick JR, Miller DL, Nagorne
Page 274 and 275: Management of liver and other dista
Page 276 and 277: years gained can be assessed, which
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Page 280 and 281: Study Country Study questions Concl
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Page 294 and 295: Table 22.6 Results of studies inves
Page 300 and 301: 22.9 Treatments 22.9.1 Surgery Seve
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Study Country Study questions Concl
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Table 22.11 Summary of findings fro
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References 1. Australian Institute
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32. Nakama, H., B. Zhang, and A.S.
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65. Sieg, A., et al., Screening for
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97. Durand-Zaleski, I., et al., Eco
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Cost effectiveness 289
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References 1. National Health and M
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Appendices
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“Zorbas et al 2 Multidisciplinary
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a pathologist-molecular biologist o
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References 1. Australian Cancer Net
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Chapter 2 — Primary prevention an
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Three Cochrane systematic reviews w
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Dates 1 January 1998 to June 2004 S
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Dates Update of 1999 document from
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Search terms MeSH terms were ‘col
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Chapter 20 — The role of systemic
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Search terms Colorectal Cancer, soc
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However, in some cases it was also
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Professor James St John Gastro ente
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Working party on emergency surgery
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Dr Russel Stitz Surgeon, Royal Bris
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14. Dr Michael Izard Radiation Onco
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Mrs Avis Mcphee Consumer (June 9 an
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DVT deep venous thrombosis ECOG Eur
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TNM tumour, node, metastasis stagin
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Chemotherapy The use of drugs (whic
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Malignant Cancerous Malignant cells
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with a specific disease might survi
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