{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:16:13Z","timestamp":1790810173470,"version":"4.1.0"},"reference-count":68,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"6","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Global Oncology"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p>To provide expert guidance to clinicians and policymakers in resource-constrained settings on the management of patients with late-stage colorectal cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>ASCO convened a multidisciplinary, multinational Expert Panel that reviewed existing guidelines, conducted a modified ADAPTE process, and used a formal consensus process with additional experts for two rounds of formal ratings.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Existing sets of guidelines from four guideline developers were identified and reviewed; adapted recommendations from five guidelines form the evidence base and provided evidence to inform the formal consensus process, which resulted in agreement of \u2265 75% on all recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>RECOMMENDATIONS<\/jats:title><jats:p>Common elements of symptom management include addressing clinically acute situations. Diagnosis should involve the primary tumor and, in some cases, endoscopy, and staging should involve digital rectal exam and\/or imaging, depending on resources available. Most patients receive treatment with chemotherapy, where chemotherapy is available. If, after a period of chemotherapy, patients become candidates for surgical resection with curative intent of both primary tumor and liver or lung metastatic lesions on the basis of evaluation in multidisciplinary tumor boards, the guidelines recommend patients undergo surgery in centers of expertise if possible. On-treatment surveillance includes a combination of taking medical history, performing physical examinations, blood work, and imaging; specifics, including frequency, depend on resource-based setting. Additional information is available at www.asco.org\/resource-stratified-guidelines .<\/jats:p><\/jats:sec>","DOI":"10.1200\/jgo.19.00367","type":"journal-article","created":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T20:02:11Z","timestamp":1583784131000},"page":"414-438","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":147,"title":["Treatment of Patients With Late-Stage Colorectal Cancer: ASCO Resource-Stratified Guideline"],"prefix":"10.1200","author":[{"given":"E. Gabriela","family":"Chiorean","sequence":"first","affiliation":[{"name":"University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Govind","family":"Nandakumar","sequence":"additional","affiliation":[{"name":"Columbia Asia Hospitals, Bangalore, India"},{"name":"Weill Cornell Medical College, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Temidayo","family":"Fadelu","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Temin","sequence":"additional","affiliation":[{"name":"American Society of Clinical Oncology, Alexandria, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley Efrain","family":"Alarcon-Rozas","sequence":"additional","affiliation":[{"name":"Clinica Angloamericana, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suyapa","family":"Bejarano","sequence":"additional","affiliation":[{"name":"Excelmedica, Liga Contra el Cancer Honduras, San Pedro Sulal, Honduras"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adina-Emilia","family":"Croitoru","sequence":"additional","affiliation":[{"name":"Fundeni Clinical Institute, Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surbhi","family":"Grover","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pritesh V.","family":"Lohar","sequence":"additional","affiliation":[{"name":"HCG Cancer Center, Vadodara, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Odhiambo","sequence":"additional","affiliation":[{"name":"University of Nairobi, College of Health Sciences, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se Hoon","family":"Park","sequence":"additional","affiliation":[{"name":"Samsung Medical Center, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika Ruiz","family":"Garcia","sequence":"additional","affiliation":[{"name":"Insituto Nacional De Cancerologia, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Teh","sequence":"additional","affiliation":[{"name":"Philippine Association of HPB Surgeons\/Makati Medical Center, Makati City, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azmina","family":"Rose","sequence":"additional","affiliation":[{"name":"Independent Colorectal Patient Representative, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassem","family":"Zaki","sequence":"additional","affiliation":[{"name":"Dartmouth-Hitchcock Medical Center, Lebanon, NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary D.","family":"Chamberlin","sequence":"additional","affiliation":[{"name":"Dartmouth-Hitchcock Medical Center, Lebanon, NH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1075-122X.2006.00199.x"},{"key":"B4","doi-asserted-by":"crossref","unstructured":"Horton S, Gauvreau CL: Cancer in low- and middle-income countries: An economic overview, in Gelband H, Jha P, Sankaranarayanan R, et al (eds): Cancer: Disease Control Priorities, Volume 3 (ed 3). Washington, DC, The International Bank for Reconstruction and Development\/The World Bank, 2015","DOI":"10.1596\/978-1-4648-0349-9_ch16"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.001"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2011-000172"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2018.0021"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx224"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdw235"},{"key":"B13","doi-asserted-by":"crossref","first-page":"379","DOI":"10.47102\/annals-acadmedsg.V44N10p379","volume":"44","author":"Singapore Cancer Network (SCAN) Colorectal Cancer Systemic Therapy Workgroup","year":"2015","journal-title":"Ann Acad Med Singapore"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-015-0801-z"},{"key":"B15","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1007\/s12094-015-1434-4","volume":"17","author":"Aranda E","year":"2015","journal-title":"Clin Transl Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e3182567e13"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31828cb66c"},{"key":"B18","unstructured":"Cancer Council Australia Colorectal Cancer Guidelines Working Party: Clinical practice guidelines for the prevention, early detection and management of colorectal cancer: Short-form summary of NHMRC approved recommendations. Sydney, 2017. https:\/\/wiki.cancer.org.au\/australia\/Guidelines:Colorectal_cancer"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx738"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2015.06.006"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.1474"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.71.9807"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdn735"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2007.07.017"},{"key":"B27","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1002\/bjs.9449","volume":"101","author":"Lykoudis PM","year":"2014","journal-title":"Br J Surg"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.78.9636"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.11.037"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00161-8"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2016.017905"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.01616"},{"key":"B33","unstructured":"Pan American Health Organization: Safe Handling of Hazardous Chemotherapy Drugs in Limited-Resource Settings. Washington, DC, PAHO, 2013"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.05.113"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.9898"},{"key":"B36","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1002\/1097-0142(19890315)63:6+<1026::AID-CNCR2820631307>3.0.CO;2-R","volume":"63","author":"O\u2019Connell MJ","year":"1989","journal-title":"Cancer"},{"key":"B37","doi-asserted-by":"crossref","first-page":"238146831772965","DOI":"10.1177\/2381468317729650","volume":"2","author":"Toumazis I","year":"2017","journal-title":"MDM Policy Pract"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.16.2938"},{"issue":"12","key":"B39","first-page":"51","volume":"14","author":"Douillard JY","year":"2000","journal-title":"Oncology (Williston Park)"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.09.0928"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1403108"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032691"},{"key":"B43","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.clcc.2013.04.006","volume":"12","author":"Petrelli F","year":"2013","journal-title":"Clin Colorectal Cancer"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.38.9650"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.9930"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdi246"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.44.8308"},{"key":"B48","doi-asserted-by":"crossref","first-page":"63","DOI":"10.4103\/2008-7802.161068","volume":"6","author":"Davari M","year":"2015","journal-title":"Int J Prev Med"},{"key":"B49","doi-asserted-by":"crossref","first-page":"71164","DOI":"10.18632\/oncotarget.17029","volume":"8","author":"Wu B","year":"2017","journal-title":"Oncotarget"},{"key":"B50","doi-asserted-by":"crossref","first-page":"e0175409","DOI":"10.1371\/journal.pone.0175409","volume":"12","author":"Carvalho AC","year":"2017","journal-title":"PLoS One"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.02459"},{"key":"B52","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1245\/s10434-006-9215-5","volume":"14","author":"Tsai MS","year":"2007","journal-title":"Ann Surg Oncol"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2006.04.012"},{"key":"B54","first-page":"283","volume":"4","author":"Kanas GP","year":"2012","journal-title":"Clin Epidemiol"},{"key":"B55","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.hpb.2015.12.004","volume":"18","author":"Hadden WJ","year":"2016","journal-title":"HPB"},{"key":"B56","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/DCR.0b013e3182739f5e","volume":"56","author":"Mar\u00edn C","year":"2013","journal-title":"Dis Colon Rectum"},{"key":"B57","doi-asserted-by":"crossref","first-page":"e0173933","DOI":"10.1371\/journal.pone.0173933","volume":"12","author":"Wiegering A","year":"2017","journal-title":"PLoS One"},{"key":"B58","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1016\/j.ejca.2011.10.034","volume":"48","author":"Chua TC","year":"2012","journal-title":"Eur J Cancer"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.26.9340"},{"key":"B61","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s12904-018-0339-8","volume":"17","author":"Massa I","year":"2018","journal-title":"BMC Palliat Care"},{"key":"B62","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s12904-019-0427-4","volume":"18","author":"Fiorin de Vasconcellos V","year":"2019","journal-title":"BMC Palliat Care"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.2016.007385"},{"key":"B64","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1136\/ijgc-2019-000405","volume":"29","author":"Fokom Domgue J","year":"2019","journal-title":"Int J Gynecol Cancer"},{"key":"B65","doi-asserted-by":"crossref","first-page":"238212051882092","DOI":"10.1177\/2382120518820922","volume":"6","author":"Shimasaki S","year":"2019","journal-title":"J Med Educ Curric Dev"},{"key":"B66","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.1053\/j.gastro.2006.03.013","volume":"130","author":"Rex DK","year":"2006","journal-title":"Gastroenterology"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.1007\/s10434-001-0347-3"},{"key":"B68","first-page":"1849","volume":"27","author":"Ciliberto D","year":"2012","journal-title":"Oncol Rep"},{"key":"B69","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.hpb.2016.03.001","volume":"18","author":"Khoo E","year":"2016","journal-title":"HPB"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i2.519"},{"key":"B71","doi-asserted-by":"crossref","first-page":"4312","DOI":"10.1245\/s10434-013-3162-8","volume":"20","author":"Araujo R","year":"2013","journal-title":"Ann Surg Oncol"},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.75.2311"},{"key":"B73","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.23.1183"},{"key":"B74","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1186\/s12885-017-3679-5","volume":"17","author":"Ungari AQ","year":"2017","journal-title":"BMC Cancer"},{"key":"B75","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2012.12"}],"container-title":["JCO Global Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JGO.19.00367","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T02:36:54Z","timestamp":1666060614000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JGO.19.00367"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":68,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1200\/JGO.19.00367"],"URL":"https:\/\/doi.org\/10.1200\/jgo.19.00367","relation":{},"ISSN":["2687-8941"],"issn-type":[{"value":"2687-8941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11]]},"assertion":[{"value":"2020-01-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}