Citations 2
International consensus on the management of large (≥20 mm) colorectal laterally spreading tumors: World Endoscopy Organization Delphi study
Rex, Douglas K. , Aihara, Hiroyuki , Bastiaansen, Barbara A.J. , Bechara, Robert , Bhatt, Amit , Bourke, Michael J. , Byeon, Jeong‐Sik , Chino, Akiko , Goldblum, John R. , Ho, Shiaw Hooi , Jung, Yunho , Kawachi, Hiroshi , Khashab, Mouen A., Khomvilai, Supakij , Messmann, Helmut , Mori, Yuichi, Nakanishi, Yukihiro , Ngamruengphong, Saowanee , Parra‐Blanco, Adolfo , Pinto, Rafael Castilho , Pioche, Mathieu , Pohl, Heiko , Rastogi, Amit , Repici, Alessandro , Sethi, Amrita , Suzuki, Noriko, Tanaka, Shinji , Vieth, Michael, Yokoi, Chizu , Saito, Yutaka , Renteln, Daniel von , Chino, Akiko , Chiu, Philip Wai Yan , Elkholy, Shaimaa , Kawachi, Hiroshi , Yamamoto, Hironori , Yang, Dong-Hoon , Saito, Yutaka , Bhatt, Amit , Bechara, Robert , Djinbachian, Roupen , Chiu, Han‐Mo , Fukami, Norio , Bhandari, Pradeep , Cardoso, Daniela, Dekker, Evelien , Draganov, Peter V. , Emura, Fabian , Haji, Amyn , Khashab, Mouen A. , Kim, Eun Ran , Maselli, Roberta , Moons, Leon M.G. , Pellisé, Maria , Singh, Rajvinder
Digestive Endoscopy | June 27, 2024 | Volume: 36 | Issue: 11 | Pages: 1253-1268
ObjectivesThere have been significant advances in the management of large (≥20 mm) laterally spreading tumors (LSTs) or nonpedunculated colorectal polyps; however, there is a lack of clear consensus on the management of these lesions with significant geographic variability especially between Eastern and Western paradigms. We aimed to provide an international consensus to better guide management and attempt to homogenize practices.MethodsTwo experts in interventional endoscopy spearheaded an evidence‐based Delphi study on behalf of the World Endoscopy Organization Colorectal Cancer Screening Committee. A steering committee comprising six members devised 51 statements, and 43 experts from 18 countries on six continents participated in a three‐round voting process. The Grading of Recommendations, Assessment, Development and Evaluations tool was used to assess evidence quality and recommendation strength. Consensus was defined as ≥80% agreement (strongly agree or agree) on a 5‐point Likert scale.ResultsForty‐two statements reached consensus after three rounds of voting. Recommendations included: three statements on training and competency; 10 statements on preresection evaluation, including optical diagnosis, classification, and staging of LSTs; 14 statements on endoscopic resection indications and technique, including statements on en bloc and piecemeal resection decision‐making; seven statements on postresection evaluation; and eight statements on postresection care.ConclusionsAn international expert consensus based on the current available evidence has been developed to guide the evaluation, resection, and follow‐up of LSTs. This may provide guiding principles for the global management of these lesions and standardize current practices.
Joint Asian Pacific Association of Gastroenterology (APAGE)–Asian Pacific Society of Digestive Endoscopy (APSDE) clinical practice guidelines on the use of non-invasive biomarkers for diagnosis of colorectal neoplasia
Wong, Martin C. S. , Chan, Andrew T. , East, James E. , Chiu, Han‐Mo , Makharia, Govind K, Weller, David , Ooi, Choon Jin , Dao, Hang Viet , Emery, Jon , Makmun, Dadang , Chauhan, Ashish , Chan, Francis K L , Wong, Martin C S , Chan, Andrew T , East, James E , Chiu, Han-Mo , Makharia, Govind K , Ooi, Choon Jin , Limsrivilai, Julajak , Ng, Siew C , Chan, Francis K.L. , Saito, Yutaka , Wu, Kaichun , Ali, Raja Affendi Raja , Ng, Siew C.
Gut | April 5, 2023 | Volume: 72 | Issue: 7 | Pages: 1240-1254
Screening for colorectal cancer (CRC) is effective in reducing CRC related mortality. Current screening methods include endoscopy based and biomarker based approaches. This guideline is a joint official statement of the Asian Pacific Association of Gastroenterology (APAGE) and the Asian Pacific Society of Digestive Endoscopy (APSDE), developed in response to the increasing use of, and accumulating supportive evidence for the role of, non-invasive biomarkers for the diagnosis of CRC and its precursor lesions. A systematic review of 678 publications and a two stage Delphi consensus process involving 16 clinicians in various disciplines was undertaken to develop 32 evidence based and expert opinion based recommendations for the use of faecal immunochemical tests, faecal based tumour biomarkers or microbial biomarkers, and blood based tumour biomarkers for the detection of CRC and adenoma. Comprehensive up-to-date guidance is provided on indications, patient selection and strengths and limitations of each screening tool. Future research to inform clinical applications are discussed alongside objective measurement of research priorities. This joint APAGE–APSDE practice guideline is intended to provide an up-to-date guide to assist clinicians worldwide in utilising non-invasive biomarkers for CRC screening; it has particular salience for clinicians in the Asia-Pacific region.