Colorectal Cancer
Conditions
Keywords
colorectal surgery, colorectal cancer, colonic stenting, emergency surgery
Brief summary
APOLLO (Acute PresentatiOn of CoLorectaL Cancer: an internatiOnal snapshot) is an international, multi-centre, prospective observational study which will address this need and aims to describe the operative and non-operative management of emergency presentations of colon and rectal cancer in an international cohort.
Detailed description
Primary aim: Describe the variation in the operative and non-operative management of emergency presentations of colon and rectal cancer in an international cohort. Secondary aims: * Identify risk factors for mortality (intraoperatively, at 30-days and at 90-days) and ostomy rates (at 30- and 90-days) in patients deemed for active management (i.e., not for palliative management) to develop a risk prediction model * Validate risk criteria of large bowel obstruction in patients with previously known colorectal cancer undergoing neoadjuvant chemotherapy or awaiting elective surgery Who? * Patients aged 18 years and above presenting to the hospital acutely with colorectal cancer (CRC) for malignant large bowel obstruction (LBO), perforation, CRC-related haemorrhage or other reasons within the data collection periods. Both those managed with and without surgery will be included * Patients with localised and metastatic disease will be included * Patients with known colorectal cancer diagnoses will be included if they present acutely (e.g., with disease progression) * Patients presenting acutely for the side effects of chemotherapy/radiotherapy of known cancers will be excluded What? Data will be collected on patients' presenting status and symptoms, patient management strategies, and intraoperative and postoperative outcomes. When? Prospectively over 2023 in consecutive 6-week data collection blocks between January and June with 90-day follow-up till September.
Interventions
None listed
Sponsors
European Student Research Network
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient pathology: Patients admitted to the hospital acutely with primary colon AND/OR rectal adenocarcinoma and referred to general/colorectal surgical departments: * Patients who are operated on for curative/palliative treatment of colorectal cancer * Patients who are referred to general surgery for assessment (irrespective of if they proceed to surgery) * New diagnoses of colorectal cancer * Extent of cancer: All patients including extra-abdominal metastatic, intra-abdominal metastatic and non-metastatic disease * Known cancer: Patients presenting for the first time with colorectal cancer AND/OR known colorectal cancer diagnosis with progression of disease. i.e. obstruction of known colorectal cancer * Patient presentation: Symptomatic presentation of colorectal cancer i.e. large bowel obstruction, haemorrhage, perforation
Exclusion criteria
* Presenting for side effects of cancer treatment * Patients with secondary cancers * Previously included in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Primary outcome | 90-day | Mortality since day of presentation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Secondary outcome 2 | 30- and 90-day | Operative mortality rates |
| Secondary outcome 3 | 30- and 90-day | Rates of primary anastomosis |
| Secondary outcome 4 | 30- and 90-day | Stoma formation and reversal rates |
| Secondary outcome 5 | 90-day | Rate and grade of surgical complications |
| Secondary outcome 1 | 30-day | Inpatient mortality, mortality since day of presentation |
| Secondary outcome 7 | 30- and 90-day | Rate of representation for patients managed nonoperatively |
| Secondary outcome8 | 30- and 90-day | Rates of radiological assessment on admission |
| Secondary outcome 9 | 30- and 90-day | Proportion of patients presenting acutely with large bowel obstruction with known colorectal cancer who had high risk criteria for obstruction (as defined by the FOXTroT obstruction criteria) at index assessment |
| Secondary outcome 6 | 30- and 90-day | Rates of stenting in those with left-sided LBO, rates of stenting in those treated with palliative intent, rate of colonic stenting complications |
Countries
United Kingdom
Outcome results
None listed