From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
The Malaysian Colorectal Cancer Clinical Practice Guidelines for surgical residents prioritize a comprehensive management approach, focusing on preoperative assessment, surgical principles, and postoperative care to improve patient outcomes and reduce morbidity and mortality. The guidelines emphasize the importance of proper preoperative assessment, including complete colonoscopy, CT scans of chest/abdomen/pelvis for staging, and MRI for rectal cancers, as highlighted in studies such as 1.
Key Components of the Guidelines
- Preoperative assessment with complete colonoscopy, CT scans, and MRI for rectal cancers
- Surgical principles emphasizing complete mesocolic excision for colon cancer and total mesorectal excision for rectal cancer, with adequate lymph node harvesting (minimum 12 nodes)
- Laparoscopic approaches when feasible, with specified resection margins (5cm for colon, 2cm for rectum, and 1mm circumferential margin)
- Selective approach to neoadjuvant therapy based on staging for rectal cancer
- Postoperative care emphasizing enhanced recovery protocols, early mobilization, and timely oral feeding
- Surveillance recommendations including regular follow-up with CEA monitoring, colonoscopy, and imaging studies for five years
Multidisciplinary Team Discussions
Multidisciplinary team discussions are emphasized for complex cases, ensuring optimal patient outcomes through collaborative decision-making, as recommended by guidelines such as 2 and 3.
Recent Guidelines and Recommendations
The most recent guidelines, such as the Pan-Asian adapted ESMO Clinical Practice Guidelines 2, provide a framework for the management of metastatic colorectal cancer, emphasizing the importance of personalized therapeutic strategies and multidisciplinary team discussions.