JSCO2016: International Session 2 Colorectal Cancer

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The 54th Annual Meeting of Japan Society of Clinical Oncology (JSCO2016)

"Renovation of Cancer Medicine in the Mature Society"



International Session 1: Lung Cancer
International Session 2: Colorectal Cancer
International Session 3: Gastric Cancer
International Session 4: Urological Cancer (Prostate and Renal Cancer)
International Session 5: Supportive Care for Adverse Events
International Session 6: Gynecological Cancer (Uterine Body Cancer and Ovarian Cancer)
International Session 7: Central Nervous System Tumor
International Session 8: New Development of Particle Beam Therapy for Cancer
International Session 9: International Cooperation in Radiation Medicine
International Session 10: Recent Advances In Cancer Immunotherapy
International Session 11: Breast Cancer
International Session 12: Pharmacology of Antitumor Agents: New Drug Application (NDA)
International Session 13: Malignant Lymphoma
International Session 14: Palliative Care
International Session 15: Radiation Therapy
International Session 16: Head and Neck Cancer
International Session 17: Skin Cancer (Malignant Melanoma)
International Session 18: Hepato-Biliary and Pancreas Cancers
International Session 19: Leukemia
International Session 20: Ethics for Clinical Research
International Session 21: Esophageal Cancer
International Session 22: Bone and Soft Tissue Tumor
FACO/JSCO Joint Symposium

Abstract Archives (in Japanese)


International Session 2: Colorectal Cancer


Colorectal cancer treatment guidelines in Japan
Eiji Oki (Department of Surgery and Science, Kyushu University Graduate School)
Japanese guidelines for the treatment of colorectal cancer were first published in 2005 by the Japanese Society for Cancer of the Colon and Rectum, and the guidelines were revised in 2009, 2010, and 2014. These guidelines incorporate the results of clinical studies of chemotherapy and describe the evidence pertaining to endoscopic submucosal dissection and endoscopic colorectal surgery. Thus, these guidelines have a very broad scope and include the latest information collected worldwide. However, we cannot use the evidence of studies conducted outside Japan without modifications owing to the following reasons: First, Japan has a special insurance system that allows all people to access all medical care facilities. Second, the standard operation for colorectal cancer in Japan is quite different from that used in western countries considering the interpretation of lymph node dissection. In addition, there might be racial differences in the sensitivity to chemotherapy and in prognostic factors. Therefore, to improve the Japanese guidelines, we should always consider these differences, and it is necessary to conduct original clinical trials in Japan to establish the Japanese guidelines.


Finding value in colon cancer
John L. Marshall (Oncology, Medicine, Georgetown University, USA)
We have made major advances in the treatment of colorectal cancer in the past two decades, tripling the survival of metastatic disease to over 30 months. We did this through the development of novel chemotherapies, biologics and now even immune therapies. We have made significant strides in our understanding of molecular profiles that predict resistance and response and most recently defines novel, consensus molecular categories to divide our patients into more useful groups enabling us to predict outcomes, best drugs to use, and enhance our research efforts. However, with all this success, we have dramatically increased the costs and burden on our national budgets. We have made cancer care into an elite service that most of the world cannot afford. We have increased the complexity such that it is becoming more difficult to keep up with the progress. We must find new ways to move forward including embracing the molecular data, collaborating on a global scale to expedite clinical research in an increasingly enriched patient population, and to train each other to create a global standard to expand access to cancer care around the world.


Recent advances in treatment for colorectal cancer in Japan (Year in review from Japan)
Hideo Baba (Department of Gastroenterological Surgery, Kumamoto University Graduate School)
The incidence and mortality rates of colorectal cancer is dramatically increasing in Japan. Annually, approximately 125,000 new cases of CRC are diagnosed and 693,900 Japanese die of CRC in recent year. The risk of developing CRC is influenced by both environmental and genetic factors. Obesity is one of the most important risk factors for colorectal cancer. Consequently, increasing evidence suggests that diabetes mellitus is associated with an elevated risk of CRC. Recent evidence indicates that metformin, which is used widely to treat diabetes mellitus, has a suppressive effect on tumorigenesis and cancer cell grow. Japanese study suggest that metformin has a potential role in the chemoprevention of colorectal cancer. Surgery provides a potentially curative option for selected patients with localized disease or limited metastatic disease. Development of less invasive surgery and image-guided surgery may result in less complications, allowing to improve survival outcomes. There is a large difference in rectal cancer treatment between Japan and other countries. Mesorectal excision with lateral lymph node dissection is the standard procedure in Japan, and a phase III clinical trial is ongoing to assess the significance. The past 20 years have witnessed remarkable progress in systemic chemotherapy for metastatic CRC because of the approval and incorporation of multiple new chemotherapeutic agents. Despite those improvements, identification of the most effective treatment for an individual patient is still mainly based on clinical considerations. The recent molecularly comprehensive investigations indicate the biological differences in CRC and the suggestion about therapeutic approaches to CRC. In this presentation, we review on recent advances in treatment of CRC in Japan.


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