Standardizing the Definition of Each Colon Cancer Segment: Delphi Consensus on Clinical Decision-Making for Oncologic Outcomes ESTANDARIZACIÓN DE LA DEFINICIÓN DE CADA SEGMENTO DE CÁNCER DE COLON: CONSENSO DELPHI SOBRE LA TOMA DE DECISIONES CLÍNICAS PARA RESULTADOS ONCOLÓGICOS
Diseases of the Colon and Rectum, cilt.68, sa.7, ss.835-844, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 68 Sayı: 7
- Basım Tarihi: 2025
- Doi Numarası: 10.1097/dcr.0000000000003739
- Dergi Adı: Diseases of the Colon and Rectum
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, PASCAL, CAB Abstracts, EMBASE
- Sayfa Sayıları: ss.835-844
- Anahtar Kelimeler: Colon cancer segment classification, Definition, Delphi consensus, Localization
- Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet
Özet
BACKGROUND: Data registries lack a definitive classification system that distinguishes different locations of colon cancer from one another. OBJECTIVE: To establish an international consensus on the definition of primary colon cancer segment locations. DESIGN: Between December 2022 and June 2023, the Delphi survey study was conducted to seek opinions from relevant international experts and eventually develop a consensus definition of each colon cancer segment. SETTING: Three-round online-based Delphi survey study. INTERVENTIONS: The online survey included 17 questions. In the first 2 rounds, participating experts were asked to rank each statement on a scale of 1 (least relevant) to 9 (most relevant). Consensus statements and definitions were revised according to the results for statements obtaining a consensus score of 7 to 9. During the third round and online meeting, definitions and statements that reached a moderate or high consensus (above 4 for more than 70% of participants) were included. MAIN OUTCOME MEASURES: The primary goal of our project was focused on precisely localizing the specific segment affected by primary colon cancer rather than identifying surgical treatment or type of resection needed for a particular segment. RESULTS: The first round included 331 experts; 301 (91%) completed the second round and 295 (98%) completed the final round. Experts strongly supported the use of a “10-cm rule” to describe colon cancer sites at the flexures and anatomical landmarks for other segments. Regarding the definition of rectosigmoid cancer, experts from United States and Europe reached a high consensus that the term rectosigmoid as a colon cancer location must be abolished in contrast to experts from Asia. The description of overlapping segments of cancers achieved a consensus of 64%. LIMITATIONS: Subjective decisions are based on individual expert clinical experience. CONCLUSIONS: This Delphi survey, the first internationally conducted consensus study, achieved a remarkable level of consensus among a panel of global experts. Ambiguity still exists regarding overlapping lesions. See Video Abstract.