Recommendation ID
CG131/2
Question
The value of prognostic factors in guiding optimal management in patients with locally excised, pathologically confirmed stage I cancer:- An observational study should be conducted, incorporating standardised assessment of pathological prognostic factors, to assess the value of the proposed prognostic factors in guiding optimal management in patients with locally excised, pathologically confirmed stage I cancer. Outcomes of interest are disease-free survival, overall survival, local and regional control, toxicity, cost effectiveness and quality of life.
Any explanatory notes
(if applicable)
Why this is important:- The NHS bowel cancer screening programme is detecting increasing numbers of stage I cancers, but the optimum management for these very early tumours is far from clear. The available studies looking at pathological risk factors have not used standardised features, either in terms of the factors included or the methods of assessment. Furthermore, although some consensus can be reached on the pathological risk factors that lead to poorer outcomes, there is no evidence about how these risk factors might be used to guide subsequent clinical management, particularly when the resection margins are considered to be clear. The therapeutic options are varied and there is no realistic prospect for a successful randomised control trial. Therefore, careful follow-up of patients whose tumours have been analysed in a standardised way to define specified pathological risk factors, and who have been treated with one of the possible options, could form the basis of an observational study.

Source guidance details

Comes from guidance
Colorectal cancer: diagnosis and management
Number
CG131
Date issued
November 2011

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 06/01/2015