Clinical Practice Guidelines - National Health and Medical Research ...

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Dr George Hruby Radiation Oncologist, Westmead Hospital, Westmead Dr Sam Ngan Radiation Oncologist, Peter MacCallum Clinic, Melbourne Associate Professor Joe Tjandra Surgeon, Royal Melbourne Hospital, Melbourne Dr Peter Gibbs Medical Oncologist, Royal Melbourne Hospital, Parkville Professor Bryan Burmeister Associate Professor, Radiation Oncology, Princess Alexandra Hospital, Brisbane Working party on follow up Dr Caroline Wright (Chair) Royal Prince Alfred Hospital Dr Russel Stitz Surgeon, Royal Brisbane Hospital, Brisbane Professor Jeremy Jass Professor Pathology McGill University, Montreal, Canada Professor Finlay Macrae Gastroenterologist Royal Melbourne Hospital Melbourne Working party on advanced disease Dr Peter Gibbs (Chair) Medical Oncologist, Royal Melbourne Hospital Parkville Dr Desmond Yip Staff Specialist in Medical Oncology, The Canberra Hospital Canberra Professor John Zalcberg Medical Oncologist, Peter MacCallum Clinic Melbourne Dr Andrew Kneebone Radiation Oncologist , Liverpool Hospital, Liverpool. Professor Bryan Burmeister Associate Professor, Radiation Oncology, Princess Alexandra Hospital, Brisbane Professor David Joseph Radiation Oncologist, Sir Charles Gairder Hospital, Nedlands Dr Francis Chu Resident Medical Officer Working party on laparoscopy Professor John Zalcberg Medical Oncologist, Peter MacCallum Clinic, Melbourne Committee membership and contributors to guidelines 319
Dr Russel Stitz Surgeon, Royal Brisbane Hospital, Brisbane Working party on psychosocial aspects Professor Afaf Girgis Director of Centre for Health Research & Psycho-oncology , The Cancer Council Ms Alison Boyes Cancer Education Research Program, Wallsend General Reviewers ACN gratefully acknowledges the assistance and advice of: • Dr Mike Liem, external consultant, is a surgical oncologist from the Netherlands with a Masters Degree in Epidemiology • Chapters 8, 11 and 13 — Dr Lincoln Israel is a Colorectal Fellow at the Royal Melbourne Hospital • Professor Peter Russell — Chapter 11 – Professor of Pathology, The University of Sydney and at Royal Prince Alfred Hospital • Dr Alison Evans — Appendix 1 – Project Officer, National Breast Cancer Centre The Australian Cancer Network would also like to gratefully acknowledge: Ms Marion Haas and Ms Siggi Zapart of Centre Health Economics Research & Evaluation (CHERE), University of Technology, Sydney, for their contribution of Chapter 22 — Cost effectiveness. Ms Hester Gascoigne of Hester Gascoigne & Associates, Canberra for editing the draft document for public consultation. Submissions to Public Consultation were made by: 1. Ms Margaret Adams Manager Cancer Support Centre Sydney Adventist Hospital 186 Fox Valley Road Wahroonga 2076 2. Ms Cleola Anderiesz Senior Project Officer National Cancer Control Initiative 1 Rathdowne Street Carlton Victoria 3125 3. Dr Robert Brodribb Clinical Liaison Officer The Cancer Council of Tasmania 320 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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There has been one trial 55 of intr
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References 1. National Institute of
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30. Zaniboni A, Labianca R, Marsoni
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57. Gastrointestinal Tumour Study G
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CHAPTER 16 ADJUVANT THERAPY FOR REC
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preoperative RT 45Gy over 5 weeks s
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This suggests that a policy of preo
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Mortality from non-cancer causes wa
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References 1. Fu KK. Interactions o
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29. Swedish Rectal Cancer Trial. Im
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Rates of intraluminal recurrence an
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Ultrasonographic screening Ultrason
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References 1. Nava HR, Pagana TJ. P
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• those with a history of psychia
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References 1. Maisey NR, Norman A,
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CHAPTER 19 RECURRENT AND ADVANCED C
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What are the recommendations for in
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References 1. National Health and M
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31. Phillips RK, Hittinger R, Bleso
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Recurrent and advanced colorectal c
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(23% compared to 12%, p
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more patients having disease down-s
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References 1. Best L, Simmonds P, B
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30. Fuchs CS, Moore MR, Harker G, V
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CHAPTER 21 MANAGEMENT OF LIVER AND
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21.1.3 Imaging controlled destructi
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Does combination systemic chemother
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References 1. Woodington FF, Waugh
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34. Wood BJ, Ramkaransingh JR, Fojo
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66. Headrick JR, Miller DL, Nagorne
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Management of liver and other dista
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years gained can be assessed, which
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‘If neither of the above cases ap
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Study Country Study questions Concl
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Study Country Comparator/ screening
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Study Country Study questions Concl
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Three United States studies investi
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Table 22.6 Results of studies inves
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22.9 Treatments 22.9.1 Surgery Seve
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Page 347 and 348: However, in some cases it was also
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