Early rectal cancer: the European Association for Endoscopic Surgery (EAES) clinical consensus conference

Mario Morino; Mauro Risio; Simon Bach; Regina Beets-Tan; Krzysztof Bujko; Yves Panis; Philip Quirke; Bjorn Rembacken; Eric Rullier; Yutaka Saito; Tonia Young-Fadok; Marco Ettore Allaix

doi:10.1007/s00464-015-4067-3

Early rectal cancer: the European Association for Endoscopic Surgery (EAES) clinical consensus conference

Mario Morino^*, Mauro Risio, Simon Bach, Regina Beets-Tan, Krzysztof Bujko, Yves Panis, Philip Quirke, Bjorn Rembacken, Eric Rullier, Yutaka Saito, Tonia Young-Fadok, Marco Ettore Allaix

^*Corresponding author for this work

Cancer and Genomic Sciences

Research output: Contribution to journal › Article › peer-review

68 Citations (Scopus)

Abstract

Background: The last 30 years have witnessed a significant increase in the diagnosis of early-stage rectal cancer and the development of new strategies to reduce the treatment-related morbidity. Currently, there is no consensus on the definition of early rectal cancer (ERC), and the best management of ERC has not been yet defined. The European Association for Endoscopic Surgery in collaboration with the European Society of Coloproctology developed this consensus conference to provide recommendations on ERC diagnosis, staging and treatment based on the available evidence.

Methods: A multidisciplinary group of experts selected on their clinical and scientific expertise was invited to critically review the literature and to formulate evidence-based recommendations by the Delphi method. Recommendations were discussed at the plenary session of the 14th World Congress of Endoscopic Surgery, Paris, 26 June 2014, and then posted on the EAES website for open discussion.

Results: Tumour biopsy has a low accuracy. Digital rectal examination plays a key role in the pre-operative work-up. Magnification chromoendoscopy, endoscopic ultrasound and magnetic resonance imaging are complementary staging modalities. Endoscopic submucosal dissection and transanal endoscopic microsurgery are the two established approaches for local excision (LE) of selected ERC. The role of all organ-sparing approaches including neoadjuvant therapies followed by LE should be formally assessed by randomized controlled trials. Rectal resection and total mesorectal excision is indicated in the presence of unfavourable features at the pathological evaluation of the LE specimen. The laparoscopic approach has better short-term outcomes and similar oncologic results when compared with open surgery.

Conclusions: The management of ERC should always be based on a multidisciplinary approach, aiming to increase the rate of organ-preserving procedures without jeopardizing survival.

Original language	English
Pages (from-to)	755-773
Number of pages	19
Journal	Surgical endoscopy
Volume	29
Issue number	4
DOIs	https://doi.org/10.1007/s00464-015-4067-3
Publication status	Published - 5 Mar 2015

Keywords

Early rectal cancer
Laparoscopy
Local excision
Neoadjuvant chemoradiation
Total mesorectal excision

ASJC Scopus subject areas

Surgery

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00464-015-4067-3

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@article{161ab252df2e4f3ca0d26ac7e1e4120d,

title = "Early rectal cancer: the European Association for Endoscopic Surgery (EAES) clinical consensus conference",

abstract = "Background: The last 30 years have witnessed a significant increase in the diagnosis of early-stage rectal cancer and the development of new strategies to reduce the treatment-related morbidity. Currently, there is no consensus on the definition of early rectal cancer (ERC), and the best management of ERC has not been yet defined. The European Association for Endoscopic Surgery in collaboration with the European Society of Coloproctology developed this consensus conference to provide recommendations on ERC diagnosis, staging and treatment based on the available evidence.Methods: A multidisciplinary group of experts selected on their clinical and scientific expertise was invited to critically review the literature and to formulate evidence-based recommendations by the Delphi method. Recommendations were discussed at the plenary session of the 14th World Congress of Endoscopic Surgery, Paris, 26 June 2014, and then posted on the EAES website for open discussion.Results: Tumour biopsy has a low accuracy. Digital rectal examination plays a key role in the pre-operative work-up. Magnification chromoendoscopy, endoscopic ultrasound and magnetic resonance imaging are complementary staging modalities. Endoscopic submucosal dissection and transanal endoscopic microsurgery are the two established approaches for local excision (LE) of selected ERC. The role of all organ-sparing approaches including neoadjuvant therapies followed by LE should be formally assessed by randomized controlled trials. Rectal resection and total mesorectal excision is indicated in the presence of unfavourable features at the pathological evaluation of the LE specimen. The laparoscopic approach has better short-term outcomes and similar oncologic results when compared with open surgery.Conclusions: The management of ERC should always be based on a multidisciplinary approach, aiming to increase the rate of organ-preserving procedures without jeopardizing survival.",

keywords = "Early rectal cancer, Laparoscopy, Local excision, Neoadjuvant chemoradiation, Total mesorectal excision",

author = "Mario Morino and Mauro Risio and Simon Bach and Regina Beets-Tan and Krzysztof Bujko and Yves Panis and Philip Quirke and Bjorn Rembacken and Eric Rullier and Yutaka Saito and Tonia Young-Fadok and Allaix, {Marco Ettore}",

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doi = "10.1007/s00464-015-4067-3",

language = "English",

volume = "29",

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T1 - Early rectal cancer

T2 - the European Association for Endoscopic Surgery (EAES) clinical consensus conference

AU - Morino, Mario

AU - Risio, Mauro

AU - Bach, Simon

AU - Beets-Tan, Regina

AU - Bujko, Krzysztof

AU - Panis, Yves

AU - Quirke, Philip

AU - Rembacken, Bjorn

AU - Rullier, Eric

AU - Saito, Yutaka

AU - Young-Fadok, Tonia

AU - Allaix, Marco Ettore

PY - 2015/3/5

Y1 - 2015/3/5

N2 - Background: The last 30 years have witnessed a significant increase in the diagnosis of early-stage rectal cancer and the development of new strategies to reduce the treatment-related morbidity. Currently, there is no consensus on the definition of early rectal cancer (ERC), and the best management of ERC has not been yet defined. The European Association for Endoscopic Surgery in collaboration with the European Society of Coloproctology developed this consensus conference to provide recommendations on ERC diagnosis, staging and treatment based on the available evidence.Methods: A multidisciplinary group of experts selected on their clinical and scientific expertise was invited to critically review the literature and to formulate evidence-based recommendations by the Delphi method. Recommendations were discussed at the plenary session of the 14th World Congress of Endoscopic Surgery, Paris, 26 June 2014, and then posted on the EAES website for open discussion.Results: Tumour biopsy has a low accuracy. Digital rectal examination plays a key role in the pre-operative work-up. Magnification chromoendoscopy, endoscopic ultrasound and magnetic resonance imaging are complementary staging modalities. Endoscopic submucosal dissection and transanal endoscopic microsurgery are the two established approaches for local excision (LE) of selected ERC. The role of all organ-sparing approaches including neoadjuvant therapies followed by LE should be formally assessed by randomized controlled trials. Rectal resection and total mesorectal excision is indicated in the presence of unfavourable features at the pathological evaluation of the LE specimen. The laparoscopic approach has better short-term outcomes and similar oncologic results when compared with open surgery.Conclusions: The management of ERC should always be based on a multidisciplinary approach, aiming to increase the rate of organ-preserving procedures without jeopardizing survival.

AB - Background: The last 30 years have witnessed a significant increase in the diagnosis of early-stage rectal cancer and the development of new strategies to reduce the treatment-related morbidity. Currently, there is no consensus on the definition of early rectal cancer (ERC), and the best management of ERC has not been yet defined. The European Association for Endoscopic Surgery in collaboration with the European Society of Coloproctology developed this consensus conference to provide recommendations on ERC diagnosis, staging and treatment based on the available evidence.Methods: A multidisciplinary group of experts selected on their clinical and scientific expertise was invited to critically review the literature and to formulate evidence-based recommendations by the Delphi method. Recommendations were discussed at the plenary session of the 14th World Congress of Endoscopic Surgery, Paris, 26 June 2014, and then posted on the EAES website for open discussion.Results: Tumour biopsy has a low accuracy. Digital rectal examination plays a key role in the pre-operative work-up. Magnification chromoendoscopy, endoscopic ultrasound and magnetic resonance imaging are complementary staging modalities. Endoscopic submucosal dissection and transanal endoscopic microsurgery are the two established approaches for local excision (LE) of selected ERC. The role of all organ-sparing approaches including neoadjuvant therapies followed by LE should be formally assessed by randomized controlled trials. Rectal resection and total mesorectal excision is indicated in the presence of unfavourable features at the pathological evaluation of the LE specimen. The laparoscopic approach has better short-term outcomes and similar oncologic results when compared with open surgery.Conclusions: The management of ERC should always be based on a multidisciplinary approach, aiming to increase the rate of organ-preserving procedures without jeopardizing survival.

KW - Early rectal cancer

KW - Laparoscopy

KW - Local excision

KW - Neoadjuvant chemoradiation

KW - Total mesorectal excision

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DO - 10.1007/s00464-015-4067-3

M3 - Article

C2 - 25609317

AN - SCOPUS:84925533367

SN - 0930-2794

VL - 29

SP - 755

EP - 773

JO - Surgical endoscopy

JF - Surgical endoscopy

IS - 4

ER -

Early rectal cancer: the European Association for Endoscopic Surgery (EAES) clinical consensus conference

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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