4
Clinical Question 1.
➤ What are the optimal methods of initial symptom management,
diagnosis, and staging for patients with late-stage colorectal cancer?
• In Basic and Limited settings, symptom management includes: symptom control,
surgical evaluation, transfusion, palliative care.
• Diagnosis includes biopsy, patholog y, endoscopy (in limited settings only).
• Options discussed include endoscopy, DRE, and imaging, dependent on resource
settings.
• See Tables 2–4 for full list of recommendations.
Diagnosis
Treatment
Clinical Question 2.
➤ What are the optimal systemic treatments for patients with late-stage
colorectal cancer in first line?
• 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 based on evaluation in multidisciplinary tumor boards, patients are
recommended to undergo surgery in centers of expertise.
• See Table 5 for full list of recommendations.
Clinical Question 3.
➤ What are the optimal treatments for patients with late-stage
colorectal cancer who have received one prior line of therapy?
• In enhanced and maximal settings, chemotherapy is recommended and is
conditional upon what patients received in the first line.
• See Table 6 for full list of recommendations.
Clinical Question 4.
➤ What are the optimal treatments for patients with late-stage
colorectal cancer who have received two prior lines of therapy?
• In maximal settings, systemic therapy options are presented and are conditional
upon prior treatment.
• See Table 7 for full list of recommendations.
