TY - JOUR
T1 - Standardizing the Definition of Each Colon Cancer Segment
T2 - Delphi Consensus on Clinical Decision-Making for Oncologic Outcomes
AU - Colon Cancer Delphi Consensus Study Group
AU - Kuzu, Mehmet Ayhan
AU - Benlice, Cigdem
AU - Parvaiz, Amjad
AU - Gorgun, Emre
AU - Bertelsen, Claus A.
AU - Wexner, Steven D.
AU - Dozois, Eric J.
AU - Hohenberger, Werner
AU - Miskovic, Danilo
AU - Sugihara, Konichi
AU - Spinelli, Antonino
AU - Wiggers, Theo
AU - Lee, Woo Yong
AU - Möslein, Gabriela
AU - Tsarkov, Petr
AU - Basany, Eloy Espin
AU - Patrón Uriburu, Juan Carlos
AU - Perez, Rodrigo Olivia
AU - Lynch, Craig
AU - Liu, Zheng
AU - Hahnloser, Dieter
AU - Nilsson, Per J.
AU - Chowdri, Nisar Ahmad
AU - Brown, Gina
AU - Rouanet, Philippe
AU - Madoff, Robert D.
AU - West, Nick P.
AU - Sahin, Turgut
AU - Elhan, Atilla Halil
AU - Bordeianou, Liliana G.
AU - Abedrapo, Mario
AU - Adamina, Michel
AU - Aguilar, Julio Garcia
AU - Aigner, Felix
AU - Aiupov, Rustem
AU - Akyol, Cihangir
AU - Aly, Emad H.
AU - Amorim, Edgar
AU - Andersen, Per Vadgaard
AU - Ando, Koji
AU - Araujo, Sergio Eduardo Alonso
AU - Asplund, Dan
AU - Atallah, Sam
AU - Avellaneda, Nicolas
AU - Azevedo, Jose
AU - Baca, Bilgi
AU - Bai, Junge
AU - Balaban, Vladimir
AU - Baral, Joerg
AU - Chung, Soon Sup
N1 - Publisher Copyright:
© The ASCRS 2025.
PY - 2025/7
Y1 - 2025/7
N2 - 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.
AB - 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.
KW - Colon cancer segment classification
KW - Definition
KW - Delphi consensus
KW - Localization
UR - https://www.scopus.com/pages/publications/105003165099
U2 - 10.1097/DCR.0000000000003739
DO - 10.1097/DCR.0000000000003739
M3 - Article
C2 - 40214091
AN - SCOPUS:105003165099
SN - 0012-3706
VL - 68
SP - 835
EP - 844
JO - Diseases of the Colon and Rectum
JF - Diseases of the Colon and Rectum
IS - 7
ER -
