Gastroenterologie
a hepatologie

An example of a multidisciplinary approach for the treatment of metastatic rectal carcinoma

Jaroslav Pažin¹, Daniel Langer ^{Orcid.org  1}, Mojmír Kasalický ^{Orcid.org  2,3}

+ Affiliation
¹ Chirurgická klinika 2. LF UK a ÚVN – VFN Praha
² Chirurgická klinika, 2. LF UK a ÚVN – VFN Praha
³ Fakulta zdravotníctva a sociálnej práce, Trnavská univerzita v Trnave

Summary

The Czech Republic has occupied the top position in the worldwide incidence of colorectal cancer (CRC) long-term. In the Czech Republic, CRC is primarily diagnosed in more than 8,000 patients annually and about 4,000 people per year die from this disease. About one-half of cases are diagnosed at the advanced stage. The tumour is identified in the rectal area in more than a quarter of patients. Trends in the treatment of CRC tend to direct patients to surgery and oncology centres. Precise determination of the tumour is crucial for management during the therapeutic process. Despite a number of advances in treatment, radical surgery still takes precedence in multidisciplinary treatment approaches. The main therapeutic goal of the multidisciplinary approach is personalisation of the treatment, extension of survival time and improvement in quality of life. The authors present a case of a 36-year-old patient with metastatic rectal cancer, who underwent five more-or-less invasive surgical interventions based on coordination of therapy in a multidisciplinary team over a period of 5 years. Similarly, neoadjuvant planning and subsequent chemotherapy and biological treatment are among the modern principles of metastatic CRC treatment. The aim of this case was to highlight the advantages of multidisciplinary therapeutic approaches in a patient with metastatic CRC in the lungs and adrenal glands.

Keywords

colorectal cancer, metastatic rectal cancer, multidisciplinary approach

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Literature

1. Dušek L (ed.). Czech cancer care in numbers 2008−2009. Praha: Grada Publishing 2009.
2. International Agency for Research on Cancer, World Health Organization. GLOBOCAN 2012: Estimated Cancer Incidence, Mortality, and Prevalence Worldwide in 2012. Cancer fact sheets. [online]. Available from: http: //globocan.iarc.fr/Pages/fact_sheets_cancer.aspx.
3. Ústav zdravotnickýc informací a statistiky ČR. [online]. Dostupné z: www.uzis.cz.
4. Grega T, Májek O, Ngo O et al. Současné principy screeningu kolorektálního kracinomu – od oportunního k populačnímu screeningovému programu. Gastroent Hepatol 2016; 70 (5): 383–392. doi: 10.14735/amgh2016383.
5. Langer D, Kalvach J, Tučková I et al. Da Vinci asistovaná léčba karcinomu rekta – průběžné výsledky nerandomizované studie. Rozhl Chir 2015; 94 (12): 526−530.
6. Ryska M, Langer D. Chirurgická léčba kolorektálního karcinomu. Onkologie 2013; 7 (4): 179–182.
7. Janeczko LL. rectal cancer response to preop chemoradiation doesn’t rule out nodal disease. Medscape 2017. [online]. Available from: www.medscape.com/viewarticle/882730?src=rss.
8. Pennathur A, Abbas G, Qureshi I et al.  Radiofrequency ablation for the treatment of pulmonary metastases. Ann Thorac Surg 2009; 87 (4): 1030–1036. doi: 10.1016/j.athoracsur.2008.12.061.
9. Lam KY, Lo CY. Metastatic tumours of the adrenal glands: a 30-year experience in a teaching hospital. Clin Endocrinol (Oxf) 2002; 56 (1): 95–101.
10. Gross MD, Shapiro B, Francis IR et al. Scintigraphic evaluation of clinically silent adrenal masses. J Nucl Med 1994; 35 (7): 1145–1152.
11. Chong S, Lee KS, Kim HY et al. Integrated PET-CT for the characterization of adrenal gland lesions in cancer patients: diagnostic efficacy and interpretation pitfalls. Radiographics 2006; 26 (6): 1811–1824.
12. Whiteman AR, Dhesi JK, Walker D. The high-risk surgical patient. A role for a multi-disciplinary team approach?  Br J Anaesth 2016; 116 (3): 311–314. doi: 10.1093/bja/aev355.