Kuzu, MA; Benlice, C; Parvaiz, A; Gorgun, E; Bertelsen, CA; Wexner, SD; Dozois, EJ; ... Fernandez, LM; + view all Kuzu, MA; Benlice, C; Parvaiz, A; Gorgun, E; Bertelsen, CA; Wexner, SD; Dozois, EJ; Hohenberger, W; Miskovic, D; Sugihara, K; Spinelli, A; Wiggers, T; Lee, WY; Möslein, G; Tsarkov, P; Basany, EE; Patrón Uriburu, JC; Perez, RO; Lynch, C; Liu, Z; Hahnloser, D; Nilsson, PJ; Chowdri, NA; Brown, G; Rouanet, P; Madoff, RD; West, NP; Sahin, T; Elhan, AH; Bordeianou, LG; Abedrapo, M; Adamina, M; Aguilar, JG; Aigner, F; Aiupov, R; Akyol, C; Aly, EH; Amorim, E; Andersen, PV; Ando, K; Araujo, SEA; Asplund, D; Atallah, S; Avellaneda, N; Azevedo, J; Baca, B; Bai, J; Balaban, V; Baral, J; Bardakcioglu, O; Behm, K; Belgers, HJ; Benecke, C; Benno, S; Benz, S; Bergamaschi, R; Berger, DL; Bianchi, PP; Biondo, S; Boni, L; Bugra, D; Bundgaard, L; Byrne, C; Carvello, M; Chand, M; Chew, MH; Choen, FS; Christoph, I; Chung, SS; Cirocco, WC; Cohan, J; Consten, ECJ; Cotte, E; Coyne, P; Crolla, R; Croner, R; Cunha, M; D'Hoore, A; Dacanal, FM; Daneri, MD; Davids, JS; Davies, J; de Manzini, N; de Wilt, JHW; de Beche-Adams, T; Dekker, JW; Delaney, CP; Delrio, P; Dennett, E; Dutra Vila, RD; Dimitri, C; Dzhumabaev, K; Elliot, AH; Eray, İC; Erygin, D; Evans, C; Faes, S; Faucheron, JL; Feoktistov, D; Fernandez, LM; - view fewer (2025) Standardizing the Definition of Each Colon Cancer Segment: Delphi Consensus on Clinical Decision-Making for Oncologic Outcomes. Diseases of the Colon and Rectum , 68 (7) pp. 835-844. 10.1097/DCR.0000000000003739.

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Abstract

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.

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