Skip to main content navigationSkip to main content
ASCRS U
  • Home
  • Favorites
  • Notes
  • Prime PubMed
  • CME
  • Mobile
  • Browse
Log in
Fundamentals of Rectal Cancer SurgeryFundamentals of Rectal Cancer Surgery

Tags

Type your tag names separated by a space and hit enter

+

Role of Tumor Board

Role of Tumor Board is a topic covered in the Fundamentals of Rectal Cancer Surgery.

To view the entire topic, please log in or purchase a subscription.

ASCRS U Education Portal is the one-stop place for all things related to colorectal surgery. Provided by the American Society of Colon & Rectal Surgeons. Powered by Unbound Medicine. Explore these free sample topics:

ASCRS U

Anatomy and Embryology of the Colon, Rectum, and AnusAnatomy and Embryology of the Colon, Rectum, and Anus

Finding the correct TME planeFinding the correct TME plane

Colonic Diverticular DiseaseColonic Diverticular Disease

Surgical Management of Ulcerative ColitisSurgical Management of Ulcerative Colitis

-- The first section of this topic is shown below --

Multidisciplinary Tumor Board

The multidisciplinary tumor board has an increasing role in the multimodality management of rectal cancer.[1] The tumor board facilitates bringing together the expertise of different specialists, including the rectal cancer surgeon, medical and radiation oncologists, pathologist, radiologist, genetic counselor, and other surgical specialists including hepatobiliary surgeons, and others. The value of the multidisciplinary tumor board is indicated by a change in management decisions in as many as 50% of rectal cancer cases.[2]

Through NAPRC it is considered a best practice to discuss all rectal cancer cases prior to therapy in a multidisciplinary tumor board, except in the highest-volume centers where that is simply not feasible. The NAPRC permits those programs who have 100 or more cases in a year, to give governance to the rectal cancer program director to develop a documented policy in which criteria are established for which patients are to be presented.

The recommendation for local excision depends on favorable histologic characteristics and superficial depth of invasion as assessed on imaging with the absence of obvious nodal involvement. The recommendation for neoadjuvant chemotherapy and radiotherapy depends on imaging assessment of T- and N-stage as well as anticipated circumferential resection margin. The recommendation for sphincter preserving resection depends on assessment of sphincter invasion and anorectal function. The recommendation for en bloc resection of adjacent organs depends on assessment of invasion of anterior pelvic organs as well as lateral and posterior pelvic anatomy. Lastly, the recommendation for curative resection depends on assessment of the resectability of distant metastases, if present. The management of distant metastases and the primary rectal cancer is certainly a multidisciplinary undertaking. If the distant metastasis is isolated, there is potential for curative resection of both the metastasis and primary lesion either at the same time or in staged surgeries.

The management of Stage IV patients is highly individualized, and tumor board presentation is particularly valuable in this group. If distant metastases are multiple and the primary lesion is asymptomatic, chemotherapy may be used to manage the distant metastases. However, the team must be mindful of the potential for complications related to unresected primary tumors. Symptoms from the primary can be treated using radiation or surgery. Radiation therapy is particularly useful for palliating bleeding from the primary tumor. Surgery may be used to divert or resect the symptomatic primary lesion in the presence of stable distant metastases in an otherwise fit patient.

-- To view the remaining sections of this topic, please log in or purchase a subscription --

Multidisciplinary Tumor Board

The multidisciplinary tumor board has an increasing role in the multimodality management of rectal cancer.[1] The tumor board facilitates bringing together the expertise of different specialists, including the rectal cancer surgeon, medical and radiation oncologists, pathologist, radiologist, genetic counselor, and other surgical specialists including hepatobiliary surgeons, and others. The value of the multidisciplinary tumor board is indicated by a change in management decisions in as many as 50% of rectal cancer cases.[2]

Through NAPRC it is considered a best practice to discuss all rectal cancer cases prior to therapy in a multidisciplinary tumor board, except in the highest-volume centers where that is simply not feasible. The NAPRC permits those programs who have 100 or more cases in a year, to give governance to the rectal cancer program director to develop a documented policy in which criteria are established for which patients are to be presented.

The recommendation for local excision depends on favorable histologic characteristics and superficial depth of invasion as assessed on imaging with the absence of obvious nodal involvement. The recommendation for neoadjuvant chemotherapy and radiotherapy depends on imaging assessment of T- and N-stage as well as anticipated circumferential resection margin. The recommendation for sphincter preserving resection depends on assessment of sphincter invasion and anorectal function. The recommendation for en bloc resection of adjacent organs depends on assessment of invasion of anterior pelvic organs as well as lateral and posterior pelvic anatomy. Lastly, the recommendation for curative resection depends on assessment of the resectability of distant metastases, if present. The management of distant metastases and the primary rectal cancer is certainly a multidisciplinary undertaking. If the distant metastasis is isolated, there is potential for curative resection of both the metastasis and primary lesion either at the same time or in staged surgeries.

The management of Stage IV patients is highly individualized, and tumor board presentation is particularly valuable in this group. If distant metastases are multiple and the primary lesion is asymptomatic, chemotherapy may be used to manage the distant metastases. However, the team must be mindful of the potential for complications related to unresected primary tumors. Symptoms from the primary can be treated using radiation or surgery. Radiation therapy is particularly useful for palliating bleeding from the primary tumor. Surgery may be used to divert or resect the symptomatic primary lesion in the presence of stable distant metastases in an otherwise fit patient.

There's more to see -- the rest of this topic is available only to subscribers.

Last updated: September 17, 2021

Citation

"Role of Tumor Board." Fundamentals of Rectal Cancer Surgery, 2021. ASCRS U, www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831005/all/Role of Tumor Board.
Role of Tumor Board. Fundamentals of Rectal Cancer Surgery. 2021. https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831005/all/Role of Tumor Board. Accessed March 21, 2023.
Role of Tumor Board. (2021). In Fundamentals of Rectal Cancer Surgery https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831005/all/Role of Tumor Board
Role of Tumor Board [Internet]. In: Fundamentals of Rectal Cancer Surgery. ; 2021. [cited 2023 March 21]. Available from: https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831005/all/Role of Tumor Board.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Role of Tumor Board ID - 2831005 Y1 - 2021/09/17/ BT - Fundamentals of Rectal Cancer Surgery UR - https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831005/all/Role of Tumor Board DB - ASCRS U DP - Unbound Medicine ER -
ᐸ PreviousNext ᐳ
Try the app for free!

1. Download the ASCRS U app by Unbound Medicine

2. Select Try/Buy and follow instructions to begin your free 30-day trial

You can cancel anytime within the 30-day trial, or continue using ASCRS U to begin a 1-year subscription ($39.95)
Appstore
Google Play
Grapherence® [↑2]
    • Fundamentals of Rectal Cancer Surgery
    • Background
    • Rectal Anatomy
    • Rectal Cancer Biology and Hereditary Cancer Syndromes
    • Rationale for Multi-Modality Therapy
    • Preoperative Issues
    • Preoperative Staging
    • Role of Tumor Board
    • Indications for Preoperative Neoadjuvant Therapy
    • Local Excision
    • Indications for LAR Versus Intersphincteric Resection Versus APR
    • Indications for Extended Resection
    • Preoperative Preparation
    • Interoperative
    • Patient Positioning and Equipment for Rectal Cancer Surgery
    • Inferior Mesenteric Artery
    • Inferior Mesenteric Vein (IMV)
    • Splenic Flexure Mobilization
    • Surgical Techniques for Length
    • Technique of Total Mesorectal Excision (TME)
    • Tailored Mesorectal Excision (TME)
    • Bowel Transection and Anastomosis
    • Indications for Fecal Diversion
    • Abdominoperineal Resection
    • Standardized Operative Report
    • Management of Intraoperative Vascular and Urinary Complications
    • Postoperative Issues
    • Rectal Cancer Pathology Assessment
    • Adjuvant Therapy for Rectal Adenocarcinoma
    • Surveillance After Rectal Cancer Treatment
    • Management of Local Recurrences
    • Short-Term Complications - Anastomotic
    • Short-Term Complications - Urinary
    • Ostomy Complications and Management
    • Long-Term Complications – Bowel Dysfunction
    • Long-Term Complications - Sexual Dysfunction and Its Management
    • Parastomal and Perineal Hernias
    • Impact of Postoperative Complications On Oncologic Outcomes
    • Course Complete
    • Final Assessment
Grapherence® [↑2]
Search PRIME PubMed

Related Topics

  • Management of Local Recurrences
Your free 1 year of online access expired  .

Want to regain access to ASCRS U?

Note: Your username may be different from the email address used to register your account.

Contact Support

If you need further assistance, please contact Support.
  • unboundmedicine.com/support
  • support@unboundmedicine.com
  • 610-627-9090(Monday - Friday, 9 AM - 5 PM EST.)
Password reset sent
Username sent

Log In

ASCRS U Education Portal

Individual subscription from ASCRSLog in
A ASCRS U subscription is required to
Already have an account?Log In
Want to read the entire topic?
ASCRS offers multipe educational resources for a solid foundation in the evaluation and management of colorectal disease.
Purchase a subscriptionI’m already a subscriber
Browse sample topics
Feedback
Message
Preferred form of contact
Best time to call:
Send Message
logo
  • Home
  • Contact Us
  • Privacy / Disclaimer
  • Terms of Service
  • Log in

American Society of Colon and Rectal Surgeons & Unbound Medicine, Inc. All rights reserved.

Powered By
6.0-3971