Cancer最新文献

{"title":"Stronger together: Paid leave and health insurance policies and access to cancer care for the working population in the United States","authors":"K. Robin Yabroff PhD, Ya-Chen Tina Shih PhD, Cathy J. Bradley MPA, PhD","doi":"10.1002/cncr.35964","DOIUrl":"https://doi.org/10.1002/cncr.35964","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 13","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144515007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The current and future role of systemic therapy in non–muscle-invasive bladder cancer","authors":"Alon Lazarovich MD, MBA,&nbsp;Randy F. Sweis MD","doi":"10.1002/cncr.35966","DOIUrl":"https://doi.org/10.1002/cncr.35966","url":null,"abstract":"<p>Non–muscle-invasive bladder cancer (NMIBC) categorizes early-stage urothelial carcinoma that has not invaded the bladder's muscle layer. Although it is initially treatable with transurethral resection, NMIBC has a high risk of recurrence and progression, which necessitates prolonged surveillance and intravesical therapies. Intravesical bacillus Calmette–Guérin (BCG), originally developed as a tuberculosis vaccine, has proven effective in reducing recurrence and delaying progression in NMIBC. Notably, BCG immunotherapy was among the first treatments to demonstrate that activating the immune system could control localized urothelial cancer. Although there has been recent growth in novel intravesical therapies for patients with BCG-unresponsive disease, options remain limited, and radical cystectomy is still frequently performed. Recent advances in systemic therapies, especially immunotherapies targeting the programmed cell death protein 1/programmed death ligand 1 pathway, have now affected NMIBC, with pembrolizumab receiving regulatory approval. This development has spurred numerous clinical trials investigating systemic therapeutic agents in NMIBC alone or in combination with other modalities such as intravesical therapy or radiation to improve outcomes. To understand the current landscape in this clinical space, a systematic review of systemic therapy in NMIBC was performed. Current data and ongoing studies that use systemic agents to treat this disease are presented. Despite recent progress in this domain, there remains a substantial need for more effective treatments with fewer toxicities for NMIBC. Future trials will be essential for optimizing these therapies and improving patient outcomes.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 13","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35966","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic myeloid leukemia outcomes according to baseline risk and first-line treatment in real-world settings: Data from the Italian Network/CML Campus","authors":"Valentina Giai MD, PhD,&nbsp;Tiziana Rosso MSc, PhD,&nbsp;Fausto Castagnetti MD, PhD,&nbsp;Patrizia Pregno MD,&nbsp;Massimiliano Bonifacio MD, PhD,&nbsp;Isabella Capodanno MD,&nbsp;Mario Tiribelli MD, PhD,&nbsp;Fabio Stagno MD, PhD,&nbsp;Giovanni Caocci MD, PhD,&nbsp;Antonella Gozzini MD,&nbsp;Luigiana Luciano MD,&nbsp;Sara Galimberti MD, PhD,&nbsp;Monica Bocchia MD, PhD,&nbsp;Andrea Patriarca MD,&nbsp;Giuseppe Lanzarone MD,&nbsp;Bruno Martino MD,&nbsp;Anna Guella MD,&nbsp;Anna Rita Scortechini MD,&nbsp;Carmen Fava MD, PhD,&nbsp;Claudio Fozza MD, PhD,&nbsp;Simona Sica MD, PhD,&nbsp;Nicola Di Renzo MD,&nbsp;Pellegrino Musto MD, PhD,&nbsp;Domenico Pastore MD, PhD,&nbsp;Alessandro Maggi MD,&nbsp;Michele Pizzuti MD,&nbsp;Lorella Maria Antonia Melillo MD,&nbsp;Angelo Michele Carella MD, PhD,&nbsp;Giuseppe Tarantini MD,&nbsp;Anna Mele MD,&nbsp;Elisabetta Calistri MD,&nbsp;Maria Rosaria Coppi MD,&nbsp;Fabio Saccona MSc,&nbsp;Emilia Scalzulli MD,&nbsp;Beatrice Battaglio MD,&nbsp;Miriam Iezza MD,&nbsp;Cinzia Bitetti MD,&nbsp;Roberto Freilone MD,&nbsp;Gianantonio Rosti MD,&nbsp;Francesco Albano MD, PhD,&nbsp;Fabrizio Pane MD, PhD,&nbsp;Giorgina Specchia MD, PhD,&nbsp;Giovannino Ciccone MD, PhD,&nbsp;Giuseppe Saglio MD, PhD,&nbsp;Massimo Breccia MD","doi":"10.1002/cncr.35963","DOIUrl":"https://doi.org/10.1002/cncr.35963","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Improved outcome has been reported in chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKIs) in sponsored trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a multicenter prospective cohort study of consecutive patients with newly diagnosed chronic phase CML from 19 regions in Italy. Baseline treatments and prognostic factors on time to first optimal molecular response (≥ molecular response 3, MR3), time to disease progression, time to death from CML, and overall survival (OS) were analyzed using multivariable Fine and Gray models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The authors included 1433 CML patients: 49% (median age, 70 years) treated with frontline imatinib (IMA), and 51% treated with second-generation TKIs (2G-TKIs; median age, 52 years). EUTOS long-term survival (ELTS) was low in 68.1% of 2G-TKIs patients, compared to 50.4% of IMA patients. Faster molecular responses were observed with 2G-TKIs within the first 6 months and maintained thereafter (subhazard ratio [sHR], 1.31; 95% confidence interval [CI], 1.15–1.50). Female gender and low ELTS risk had faster time of response. Achieving major molecular response (MMR or MR3) was associated with reduced risk of progression at 6 and 12 months. Overall, 41 patients progressed without differences between IMA and 2G-TKIs. Intermediate and high risk ELTS showed higher risk of progression and death from CML. Twenty-two CML-related deaths (16.5%) occurred mostly in the first 2 years from diagnosis, higher in 2G-TKIs patients (sHR, 1.75; 95% CI, 0.52–5.87). OS at 5 years was 88% with no clear differences between IMA and 2G-TKIs treatment after adjustment for potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study confirms faster responses with 2G-TKIs compared to IMA but similar clinical outcomes and a strong prognostic effect of ELTS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 13","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35963","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Top advances of the year: Sarcoma","authors":"Mason Vierra MD,&nbsp;Jamie Brett MD,&nbsp;Jiping Wang MD","doi":"10.1002/cncr.35965","DOIUrl":"https://doi.org/10.1002/cncr.35965","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 13","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurable residual disease (MRD) as a surrogate end point for clinical drug approval in acute myeloid leukemia (AML): Perspectives from the MRD Partnership and Alliance in AML Clinical Treatment Consortium","authors":"Michael Boyiadzis MD, MHSc,&nbsp;Andrew H. Wei MBBS, PhD,&nbsp;Bruno Paiva PharmD, PhD,&nbsp;Sylvie D. Freeman DPhil, MBChB,&nbsp;Gertjan Kaspers MD, PhD,&nbsp;Brenda Chyla PhD,&nbsp;Sarah Hersey MS, MBA,&nbsp;Reshma Patel BSc,&nbsp;Brian Maloney MS,&nbsp;Marie-Helene Blanchet Zumofen PhD, MBA,&nbsp;Marlies Van Hoef MD, PhD, MBA,&nbsp;Beate Wulff MD,&nbsp;Vanessa Obourn MA,&nbsp;Shalaka Patel PhD,&nbsp;Daniel Lopes de Menezes PhD,&nbsp;Qian Shi PhD,&nbsp;Bourras-Rezki Bengoudifa MS,&nbsp;Natalie Dimier PhD,&nbsp;Thomas J. Prior PhD,&nbsp;Gail J. Roboz MD,&nbsp;Thomas Prebet MD, PhD","doi":"10.1002/cncr.35960","DOIUrl":"https://doi.org/10.1002/cncr.35960","url":null,"abstract":"<p>Despite advances in acute myeloid leukemia (AML) treatment, significant unmet medical needs remain. Surrogate end points for overall survival can accelerate the approval of novel therapies. Measurable residual disease (MRD) is a promising surrogate end point candidate, providing a sensitive and quantitative assessment of disease burden. Numerous studies have demonstrated that negative MRD status—across diverse methodologies, assessment timepoints and thresholds, patient subgroups, and clinical settings—independently predicts improved survival. Although MRD can inform therapeutic decisions at the patient level, its formal integration as a primary surrogate end point in regulatory frameworks for clinical trials requires rigorous validation. MRD Partnership and Alliance in AML Clinical Treatment (MPAACT) is a research consortium among industry and academic leaders. MPAACT actively engages with regulatory agencies, health technology assessment bodies, technology vendors, and patient groups to establish a pathway for validating MRD as a surrogate end point in AML clinical trials. For the current article, the authors reviewed the status of MRD assessment, its use in recent clinical trials, current MRD assessment methodologies, standardization, regulatory guidance, statistical approaches, and patient access considerations necessary for MRD to become a surrogate clinical trial end point. The extensive collaboration between MPAACT, global industry, and academic partners—including data sharing and resource integration—underscores the collective commitment to advancing AML therapies. Establishing MRD as a surrogate end point could accelerate the development and approval of innovative treatments, ultimately improving patient outcomes.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 13","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35960","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy or surgical treatment of early glottic carcinoma: A population-based study from the Swedish Head and Neck Cancer Register evaluating primary treatment outcomes for patients with T1a/T1b tumors","authors":"Hedda Haugen Cange MD, PhD,&nbsp;Anders Högmo MD, PhD,&nbsp;Karl Sandström MD, PhD,&nbsp;Johan Wennerberg MD, PhD,&nbsp;Martin Beran MD, PhD,&nbsp;Karin Söderkvist MD, PhD,&nbsp;Göran Laurell MD, PhD,&nbsp;Lalle Hammarstedt-Nordenvall MD, PhD,&nbsp;Johan Reizenstein MD,&nbsp;Roland Rydell MD, PhD,&nbsp;Anna Hafström MD, PhD,&nbsp;Lovisa Farnebo MD, PhD","doi":"10.1002/cncr.35955","DOIUrl":"https://doi.org/10.1002/cncr.35955","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Radiotherapy (RT) has been the treatment of choice for T1 glottic squamous cell carcinomas with curative intent; however, transoral microsurgery (MLS) has gradually taken its place. The objective of this study was to compare the outcomes of the two treatment modalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Swedish Head and Neck Cancer Register contains records for 783 patients who had T1 glottic squamous cell carcinomas and planned to undergo either RT or MLS with curative intent from 2008 until 2019. These included 652 patients with T1a tumors and 125 patients with T1b tumors, resulting in 777 eligible patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Surgical treatment led to an increased risk of recurrence compared with RT for patients who had both T1a and T1b tumors (<i>p</i> &lt; .001). Forty-seven patients (6.0%) underwent laryngectomy after primary treatment. Patients with T1b tumors had a higher risk of undergoing laryngectomy (<i>p</i> = .01), but no significant difference in the frequency of laryngectomy was noted between the treatment modalities. Patients who had T1b tumors had a significantly worse 5-year overall survival rate compared with those who had T1a tumors, but treatment modality did not influence the overall survival rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this population-based study of 777 patients with T1 glottic squamous cell carcinomas, no significant difference in overall survival was observed at 5 years based on treatment modality (MLS or RT). Overall survival was worse for patients with T1b carcinomas, and these patients were at an elevated risk of requiring laryngectomy. An increased risk of recurrence within 3 years was observed after surgical treatment for both T1a and T1b tumors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 13","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35955","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus guideline for the management of gastric cancer with synchronous peritoneal metastases","authors":"Samuel D. Butensky MD,&nbsp;Varun V. Bansal MBBS,&nbsp;David G. Su MD,&nbsp;Muhammad Talha Waheed MBBS,&nbsp;Andrei Nikiforchin MD,&nbsp;Jorge L. Gomez-Mayorga MD,&nbsp;Elizabeth Olecki MD,&nbsp;Shannon N. Radomski MD,&nbsp;Beatrice Sun MD,&nbsp;Kiran K. Turaga MD, MPH,&nbsp;Craig G. Gunderson MD, SFHM,&nbsp;Jill Lacy MD,&nbsp;Brian D. Badgwell MD,&nbsp;Haejin In MD, MPH, MBA,&nbsp;Timothy Kennedy MD, MBA,&nbsp;Harry H. Yoon MD, MHS,&nbsp;Jonathan B. Greer MD,&nbsp;Raghav Sundar MD, PhD,&nbsp;Yanghee Woo MD,&nbsp;Peritoneal Surface Malignancies Consortium Group","doi":"10.1002/cncr.35870","DOIUrl":"https://doi.org/10.1002/cncr.35870","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gastric cancer with synchronous peritoneal metastases is a debilitating disease with limited treatment options. This article describes an update of the 2018 Chicago Consensus guidelines addressing the management of gastric cancer with synchronous peritoneal metastases in line with the most recent evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A clinical management pathway was updated through two rounds of a Delphi consensus to assess agreement levels with pathway blocks. Supporting evidence underwent evaluation using a rapid literature review. Meta-analyses were performed as appropriate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, the level of evidence in this disease subset was low to moderate. Of 124 participants in the first round, 109 (88%) responded in the second round. Strong consensus (&gt;90%) was achieved in six of eight blocks (75%) in rounds 1 and 2. A multidisciplinary preoperative assessment and diagnostic laparoscopy should be offered to all patients, whereas patients with a high burden of disease or progression should undergo nonsurgical management. Patients with stable/responsive disease and a low peritoneal carcinomatosis index should subsequently be offered treatment with regional therapeutic interventions and cytoreductive surgery. In patients who are cytology-positive, systemic therapy can be used to convert them to cytology-negative, with subsequent surgery offered according to the patient's goals of care. Meta-analysis of observational and randomized control trials revealed a survival benefit with the addition of intraperitoneal chemotherapy to cytoreductive surgery (hazard ratio, 0.52).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The consensus-driven clinical pathway for gastric cancer with synchronous peritoneal metastases offers vital clinical guidance for practitioners. There is a growing body of high-quality evidence to support management strategies, and future clinical trials are eagerly awaited.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 13","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus guideline for the management of peritoneal mesothelioma","authors":"Leanne M. Brown MD,&nbsp;Sarah G. Wilkins BS,&nbsp;Varun V. Bansal MBBS,&nbsp;David G. Su MD,&nbsp;Jorge Gomez-Mayorga MD,&nbsp;Kiran K. Turaga MD, MPH,&nbsp;Craig G. Gunderson MD, SFHM,&nbsp;Byrne Lee MD,&nbsp;Garrett M. Nash MD,&nbsp;John L. Hays MD, PhD,&nbsp;Kanwal P. Raghav MBBS, MD,&nbsp;Aliya L. Husain MD,&nbsp;Michael D. Kluger MD, MPH,&nbsp;Marjorie G. Zauderer MD,&nbsp;Hedy L. Kindler MD,&nbsp;H. Richard Alexander MD,&nbsp;Peritoneal Surface Malignancies Consortium Group","doi":"10.1002/cncr.35868","DOIUrl":"https://doi.org/10.1002/cncr.35868","url":null,"abstract":"<p>The treatment of peritoneal mesothelioma (PeM) poses significant challenges because of its rare incidence, heterogeneity, and limited clinical evidence. This commentary describes results from a national consensus aimed at addressing the management of PeM. An update of the 2018 Chicago consensus guidelines was conducted with a modified Delphi technique, which encompassed two rounds of voting. The levels of agreement for various pathway blocks were assessed. Of 101 participants responding in the first round of modified Delphi voting, 95 (94%) responded in the second round. Over 90% consensus was achieved in five of six and six of six pathway blocks in rounds 1 and 2, respectively. Observation was recommended for benign neoplasms, with guidance for interventions in the presence of symptoms or concerning clinicopathological features. For malignant pathology, management was outlined on the basis of a multidisciplinary assessment of patient characteristics, disease histology, and predictive success of medical and surgical interventions. Additional emphasis was placed on multimodal therapy for intermediate-risk and appropriate high-risk patients. A rapid review demonstrated the limited availability of data and inconclusive findings regarding optimal systemic therapy timing. There was unanimous support for considering clinical trial enrollment. Given the limited evidence, the consensus-driven pathway provides essential guidance regarding the management of PeM. To further direct clinical care, additional dedicated research to generate higher quality evidence is needed.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 13","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus guideline for the management of patients with appendiceal tumors, part 2: Appendiceal tumors with peritoneal involvement","authors":"Elizabeth L. Godfrey MD,&nbsp;Forest Mahoney BS,&nbsp;Varun V. Bansal MBBS,&nbsp;David G. Su MD,&nbsp;David N. Hanna MD,&nbsp;Felipe Lopez-Ramirez MD,&nbsp;Ekaterina Baron MD,&nbsp;Kiran K. Turaga MD, MPH,&nbsp;Al B. Benson III MD,&nbsp;Namrata Setia MD,&nbsp;Joshua H. Winer MD,&nbsp;Craig G. Gunderson MD,&nbsp;Rupen Shah MD,&nbsp;Deepa R. Magge MD,&nbsp;Ian Solsky MD, MPH,&nbsp;Cathy Eng MD,&nbsp;Oliver S. Eng MD,&nbsp;Ardaman Shergill MD, MSPH,&nbsp;John Paul Shen MD,&nbsp;Joseph Misdraji MD,&nbsp;Michael B. Foote MD,&nbsp;Wenyi Luo MD,&nbsp;Peritoneal Surface Malignancies Consortium Group","doi":"10.1002/cncr.35874","DOIUrl":"https://doi.org/10.1002/cncr.35874","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Appendiceal tumors comprise a heterogeneous group of tumors that frequently disseminate to the peritoneum. Management of appendiceal tumors is lacking high-quality data given their rarity and heterogeneity. In general, appendiceal tumor treatment is extrapolated in part from colorectal cancer or pooled studies, without definitive evidence of disease-specific benefit. Many practices are controversial and vary widely between institutions. A national consensus update of best management practices for appendiceal malignancies was performed to better standardize care. Herein, the authors present recommendations for the management of appendiceal tumors with peritoneal involvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>As previously described, modified Delphi consensus was performed to update the previous 2018 Chicago Consensus guideline. Recommendations were supported by using rapid systematic reviews of key issues in surgical and systemic therapy. Key pathology concepts and recommendations were synthesized in collaboration with content experts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A consensus-based pathway was generated for any type of non-neuroendocrine appendiceal tumor with peritoneal involvement. The first round of Delphi consensus included 138 participants, of whom 133 (96%) participated in the second round, and greater than 90% consensus was achieved for all pathway blocks. Key items included recommending evaluation for cytoreduction to most patients with low-grade peritoneal disease who are surgical candidates and to many patients with high-grade disease, as well as timing of systemic chemotherapy and surveillance protocols. Common pitfalls in pathologic classification and their clinical implications are also presented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These consensus recommendations provide guidance regarding the management of appendiceal tumors with peritoneal involvement, including a review of current evidence in the management of recurrent and unresectable disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 13","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus guideline for the management of colorectal cancer with peritoneal metastases","authors":"Kurt S. Schultz MD,&nbsp;Varun V. Bansal MBBS,&nbsp;Michael M. Wach MD,&nbsp;Neal Bhutiani MD, PhD,&nbsp;Frederick A. Godley IV MD, MBA,&nbsp;Jaeyun (Jane) Wang MD,&nbsp;Muhammad Talha Waheed MBBS,&nbsp;Joanna T. Buchheit MD,&nbsp;Emily Papai MD,&nbsp;Susan Campbell MD,&nbsp;Lauren E. Schleimer MD,&nbsp;David G. Su MD,&nbsp;Kiran K. Turaga MD, MPH,&nbsp;Craig G. Gunderson MD,&nbsp;Michael G. White MD, MSc,&nbsp;Abhineet Uppal MD,&nbsp;Kanwal P. S. Raghav MBBS, MD,&nbsp;Daniel M. Labow MD, MSc,&nbsp;Umut Sarpel MD, MSc,&nbsp;Ardaman P. Shergill MD,&nbsp;John Paul Shen MD,&nbsp;Cathy Eng MD,&nbsp;Michael B. Foote MD,&nbsp;Joel M. Baumgartner MD,&nbsp;Peritoneal Surface Malignancies Consortium Group","doi":"10.1002/cncr.35869","DOIUrl":"https://doi.org/10.1002/cncr.35869","url":null,"abstract":"<p>The peritoneum is a common site of metastases from colorectal cancer (CRC), yet controversy exists regarding optimal treatment strategies. These guidelines describe the results of a national consensus addressing the management of CRC with peritoneal metastases (CRC-PM). An update of the 2018 Chicago consensus guidelines was conducted with a modified Delphi technique. Two rounds of voting were performed to assess agreement levels on two clinical management pathways regarding synchronous and metachronous CRC-PM. Supporting evidence was evaluated via rapid literature reviews. The overall level of evidence was low in the existing literature. Of 145 participants in the first round, 136 (96.8%) responded in the second round. Over 90% consensus was achieved in most pathway blocks. For both pathways, early referral to a peritoneal surface malignancy center should be made for patients with CRC-PM. For the synchronous pathway, upfront cytoreductive surgery was deemphasized in favor of systemic therapy. For the metachronous pathway, risk stratification via clinical and pathological features was revised. For both pathways, surveillance strategies were added, including only a weak recommendation for circulating tumor DNA testing, given limited evidence of its utility in detecting and monitoring PM. The consensus-driven clinical pathways provide valuable guidance for the management of CRC-PM. There remains a need for high-quality evidence and prospective multicenter trials in this domain.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 13","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}