Annotation
literal: This is an ontology for represeting clinical practice guidelines that establishes different types of information primitives.

DataPropertyAssertion
literal: Confirm the presence of invasive cancer.

DataPropertyAssertion
literal: Evaluation of tumor size and extent of disease.

DataPropertyAssertion
literal: Medical decision of the best surgical procedure.

DataPropertyAssertion
literal: Medical decision of the best surgical procedure.

DataPropertyAssertion
literal: Diagnosis of gastrointestinal bleeding, suspected tumours and inflammatory bowel disease.

DataPropertyAssertion
literal: Tumor size evaluation and extent of disease.

DataPropertyAssertion
literal: Comprehensive metabolic evaluation.

DataPropertyAssertion
literal: Evaluation of colon cancer. PET-CT scan only if potentially curable M1 disease

DataPropertyAssertion
literal: Check for the presence of cancer cells.

DataPropertyAssertion
literal: Multidisciplinary team evaluation.

DataPropertyAssertion
literal: Genetic mutation testing.

DataPropertyAssertion
literal: Diagnosis of gastrointestinal bleeding, suspected tumours and inflammatory bowel disease.

DataPropertyAssertion
literal: Detection of BRAF V600E mutation

DataPropertyAssertion
literal: Procedure to assess the Treatment 1 action.

DataPropertyAssertion
literal: Procedure to assess the Treatment 2 action.

DataPropertyAssertion
literal: Medical decision of the best surgical procedure.

DataPropertyAssertion
literal: Removal of regional lymph nodes.

DataPropertyAssertion
literal: Procedure to assess the adjuvant therapy 1 action.

DataPropertyAssertion
literal: Procedure to assess the Adjuvant therapy 2 action.

DataPropertyAssertion
literal: Procedure to assess the Adjuvant therapy 3 action.

DataPropertyAssertion
literal: Marking of cancerous polyp site.

DataPropertyAssertion
literal: No adjuvant therapy, proceed to surveillance procedure.

DataPropertyAssertion
literal: Procedure to assess the Surveillance action.

DataPropertyAssertion
literal: Conduct a research study of an innovative therapy for colon cancer.

DataPropertyAssertion
literal: Patient surveillance.

DataPropertyAssertion
literal: Medication Recommendation for adjuvant therapy.

DataPropertyAssertion
literal: Medication recommendation for adjuvant therapy.

DataPropertyAssertion
literal: Medication recommendation for adjuvant therapy

DataPropertyAssertion
literal: Medication recommendation for adjuvant therapy.

DataPropertyAssertion
literal: Conduct a research study of an innovative therapy for colon cancer.

DataPropertyAssertion
literal: Medication recommendation for adjuvant therapy.

DataPropertyAssertion
literal: Removal of regional lymph nodes.

DataPropertyAssertion
literal: Medication Recommendation for adjuvant therapy (preferred).

DataPropertyAssertion
literal: Medication recommendation for adjuvant therapy (preferred).

DataPropertyAssertion
literal: Medication recommendation for adjuvant therapy. Grade 3-4 diarrhea is considerably higher with FLO than FOLFOX in cross study comparison.

DataPropertyAssertion
literal: Obtaining the patient's history and physical.

DataPropertyAssertion
literal: Comprehensive metabolic evaluation.

DataPropertyAssertion
literal: Tumor size evaluation and extent of disease

DataPropertyAssertion
literal: Diagnosis of gastrointestinal bleeding, suspected tumours and inflammatory bowel disease.

DataPropertyAssertion
literal: Diagnosis of gastrointestinal bleeding, suspected tumours and inflammatory bowel disease.

DataPropertyAssertion
literal: Evaluation of colon cancer. PET-CT scan is not routinely recommended.

DataPropertyAssertion
literal: Analysis of the principles of survival.

DataPropertyAssertion
literal: The patient should be put under surveillance.

DataPropertyAssertion
literal: Obtain the patient's history and physical.

DataPropertyAssertion
literal: Procedure to assess the recurrence action.

DataPropertyAssertion
literal: Comprehensive metabolic evaluation.

DataPropertyAssertion
literal: Diagnosis of gastrointestinal bleeding, suspected tumours and inflammatory bowel disease.

DataPropertyAssertion
literal: Procedure to assess the neoadjuvant theraphy action.

DataPropertyAssertion
literal: Surgical resection of any extent of the colon.

DataPropertyAssertion
literal: Medication recommendation for neoadjuvant therapy.

DataPropertyAssertion
literal: Medication recommendation for neoadjuvant therapy.

DataPropertyAssertion
literal: Medication recommendation for neoadjuvant therapy.

DataPropertyAssertion
literal: Medication recommendation for neoadjuvant therapy.

DataPropertyAssertion
literal: Confirm the presence of non-metastatic colon cancer.

DataPropertyAssertion
literal: Medication recommendation for neoadjuvant therapy.

DataPropertyAssertion
literal: Medication recommendation for neoadjuvant therapy.

DataPropertyAssertion
literal: Surgical resection of any extent of the large intestine (colon).

DataPropertyAssertion
literal: Procedure for treatment

DataPropertyAssertion
literal: Surgical resection of any extent of the large intestine (colon).

DataPropertyAssertion
literal: Procedure to acess the treatment action

DataPropertyAssertion
literal: Procedure to assess the chemotherapy action

DataPropertyAssertion
literal: Medication recommendation for treatment.

DataPropertyAssertion
literal: Medication recommendation for treatment.

DataPropertyAssertion
literal: Medication recommendation for treatment.

DataPropertyAssertion
literal: Diagnosis of intestinal bleeding, suspected tumours and inflammatory bowel disease.

DataPropertyAssertion
literal: Medication recommendation for treatment

DataPropertyAssertion
literal: Medication recommendation for treatment.

DataPropertyAssertion
literal: Medication recommendation for treatment.

DataPropertyAssertion
literal: Procedure for treatment.

DataPropertyAssertion
literal: Medication Recommendation for adjuvant therapy.

DataPropertyAssertion
literal: Medication Recommendation for adjuvant therapy

DataPropertyAssertion
literal: Adjuvant therapy.

DataPropertyAssertion
literal: Procedure to assess the surveillance action.

DataPropertyAssertion
literal: Tumor size evaluation and extent of disease.

DataPropertyAssertion
literal: Comprehensive metabolic evaluation.

DataPropertyAssertion
literal: Tumor size evaluation and extent of disease.

DataPropertyAssertion
literal: Procedure to assess the systemic theraphy action.

DataPropertyAssertion
literal: Surgical resection of any extent of the large intestine (colon)

DataPropertyAssertion
literal: Medication recommendation for systemic therapy.

DataPropertyAssertion
literal: Medication recommendation for systemic therapy.

DataPropertyAssertion
literal: Medication recommendation for systemic therapy.

DataPropertyAssertion
literal: Medication recommendation for systemic therapy.

DataPropertyAssertion
literal: Medication recommendation for systemic therapy.

DataPropertyAssertion
literal: Medication recommendation for systemic therapy.

DataPropertyAssertion
literal: Medication recommendation for systemic therapy.

DataPropertyAssertion
literal: Evaluation of tumor size and extent of disease.

DataPropertyAssertion
literal: Re-evaluation procedure

DataPropertyAssertion
literal: Procedures for adjuvant therapy.

DataPropertyAssertion
literal: Procedure for metastases converted to resectable.

DataPropertyAssertion
literal: Consider PET-CT scan.

DataPropertyAssertion
literal: Tumor size evaluation and extent of disease.

DataPropertyAssertion
literal: Diagnosis of gastrointestinal bleeding, suspected tumours and inflammatory bowel disease.

DataPropertyAssertion
literal: Procedures for a positive evolution after neoadjuvant therapy.

DataPropertyAssertion
literal: Procedures for a negative evolution after neoadjuvant therapy.

DataPropertyAssertion
literal: Preparation for the active therapy regimen.

DataPropertyAssertion
literal: Perform a full physical exam.

DataPropertyAssertion
literal: Primary treatment for metachronous metastases.

DataPropertyAssertion
literal: Preferred adjuvant treatment.

DataPropertyAssertion
literal: Resection. Hepatic artery infusion +/- 5-1FU/leucovori is also an option at institutions with experience in both the surgical and medical oncologic aspects of this procedure

DataPropertyAssertion
literal: Procedures for a positive evolution after neoadjuvant therapy.

DataPropertyAssertion
literal: Procedures for a negative evolution after neoadjuvant therapy.

DataPropertyAssertion
literal: Assessment of primary treatment procedures.

DataPropertyAssertion
literal: Preparation for chemotherapy.

DataPropertyAssertion
literal: Preparation for chemotherapy.

DataPropertyAssertion
literal: Preparation for chemotherapy.

DataPropertyAssertion
literal: Preparation for chemotherapy.

DataPropertyAssertion
literal: Therapy after first progression. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. Cetuximab is indicated in combination with innotecan-based therapy or as single-agent therapy for patients who cannot tolerate irinotecan. There are no data, nor is there a compelling rationale, to support the use of panitumumab after clinical failure on cetuximab, or the use of cetuximab after clinical failure on panitumumab. As such, the use of one of these agents after therapeutic failure on the other is not recommended. EGFR testing has no demonstrated predictive value; therefore, routine EGFR testing is not recommended. No patient should be included or excluded from cetuximab or panitumumab therapy on the basis of EGFR test results. Patients with a V600E BRAF mutation appear to have a poorer prognosis. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1 Al. Guidelines for use in clinical practice have not been established. Principles of pathologic review: -KRAS Mutation Testing: --Mutations in codons 12 and 13 in exon 2 of the coding region of the KRAS gene predict lack of response to therapy with antibodies targeted to the EGFRA. --Testing for mutations in codons 12 and 13 should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) as qualified to perform high complexity clinical laboratory (molecular pathology) testing. No specific methodology is recommended (eg, sequencing, hybridization). --The testing can be performed on formalin-fixed paraffin-embedded tissue. The testing can be performed on the primary colorectal cancers and/or the metastasis, as liter…

DataPropertyAssertion
literal: Preparation for chemotherapy.

DataPropertyAssertion
literal: Therapy after second progression For patients not able to tolerate the combination, consider single agent cetuximab or panitumumab. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. Cetuximab is indicated in combination with innotecan-based therapy or as single-agent therapy for patients who cannot tolerate irinotecan. There are no data, nor is there a compelling rationale, to support the use of panitumumab after clinical failure on cetuximab, or the use of cetuximab after clinical failure on panitumumab. As such, the use of one of these agents after therapeutic failure on the other is not recommended. EGFR testing has no demonstrated predictive value; therefore, routine EGFR testing is not recommended. No patient should be included or excluded from cetuximab or panitumumab therapy on the basis of EGFR test results. Patients with a V600E BRAF mutation appear to have a poorer prognosis. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1 Al. Guidelines for use in clinical practice have not been established. Principles of pathologic review: -KRAS Mutation Testing: --Mutations in codons 12 and 13 in exon 2 of the coding region of the KRAS gene predict lack of response to therapy with antibodies targeted to the EGFRA. --Testing for mutations in codons 12 and 13 should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) as qualified to perform high complexity clinical laboratory (molecular pathology) testing. No specific methodology is recommended (eg, sequencing, hybridization). --The testing can be performed on formalin-fixed paraffin-embedded tis…

DataPropertyAssertion
literal: Preparation for chemotherapy.

DataPropertyAssertion
literal: Preparation for therapy.

DataPropertyAssertion
literal: Preparation for chemotherapy.

DataPropertyAssertion
literal: Therapy after first progression. for patients not able to tolerate combination, consider single agent (cetuximab or panitumumab). Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. Cetuximab is indicated in combination with innotecan-based therapy or as single-agent therapy for patients who cannot tolerate irinotecan. EGFR testing has no demonstrated predictive value; therefore, routine EGFR testing is not recommended. No patient should be included or excluded from cetuximab or panitumumab therapy on the basis of EGFR test results. There are no data, nor is there a compelling rationale, to support theuse of panitumumab after clinical failure on cetuximab, or the use of cetuximab after clinical failure on panitumumab. As such, the use of one of these agents after therapeutic failure on the other is not recommended. Patients with a V600E BRAF mutation appear to have a poorer prognosis. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1A1. Guidelines for use in clinical practice have not been established.

DataPropertyAssertion
literal: Preparation for chemotherapy.

DataPropertyAssertion
literal: Preparation for chemotherapy.

DataPropertyAssertion
literal: Preparation for chemotherapy.

DataPropertyAssertion
literal: Preparation for chemotherapy.

DataPropertyAssertion
literal: Preparation for chemotherapy.

DataPropertyAssertion
literal: Primary treatment for metachronous metastases.

DataPropertyAssertion
literal: Set of exams to assess cancer recurrence given serial CEA elevation

DataPropertyAssertion
literal: Resection. Artery infusion +/- systemic 5-FU/leucovorin is also an option at institutions with experience in both the surgical and medical oncologic aspects of this procedure.

DataPropertyAssertion
literal: Adjuvant treatment.

DataPropertyAssertion
literal: Resection. Hepatic artery infusion +/- 5-1FU/leucovori is also an option at institutions with experience in both the surgical and medical oncologic aspects of this procedure

DataPropertyAssertion
literal: Repeat neoadjuvant therapy.

DataPropertyAssertion
literal: Adjuvant treatment.

DataPropertyAssertion
literal: Surveillance of tumor growth.

DataPropertyAssertion
literal: Observation (preferred for previous oxaliplatin-based therapy)

DataPropertyAssertion
literal: Medication recommendation for primary treatment.

DataPropertyAssertion
literal: Consider PET-CT scan. Re-evaluate chest/abdominal/pelvic CT in 3 months.

DataPropertyAssertion
literal: Re-evaluation of resectability.

DataPropertyAssertion
literal: Resection. Hepatic artery infusion +/- 5-1FU/leucovori is also an option at institutions with experience in both the surgical and medical oncologic aspects of this procedure.

DataPropertyAssertion
literal: Initial therapy. Discontinuation of oxaliplatin should be strongly considered from FOLFOX or CapeOX after 3-4 months of therapy (or sooner if significant neurotoxicity develops higher than grade 2) with other drugs maintained (fluoropyrimidine + bevacizumab) until time of tumor progression. Oxaliplatin may be reintroduced if it was discontinued previously for neurotoxicity rather than disease progression.

DataPropertyAssertion
literal: Initial therapy.The majority of safety and efficacy data for this regimen have been developed in Europe, where a capecitabine starting dose of 1000 mg/m2 twice daily for 14 days, repeated every 21 days, is standard. Evidence suggests that North American patients may experience greater toxicity with capecitabine (as well as with other fluoropyrimidines) than European patients, and may require a lower dose of capecitabine. The relative efficacy of CapeOx with lower starting doses of capecitabine has not been addressed in large-scale randomized trials. There is an increased risk of stroke and other arterial events, especially in those aged higher than 65 years. The use of bevacizumab may interfere with wound healing. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended.

DataPropertyAssertion
literal: Initial therapy. Discontinuation of oxaliplatin should be strongly considered from FOLFOX or CapeOX after 3-4 months of therapy (or sooner if significant neurotoxicity develops higher than grade 2) with other drugs maintained (fluoropyrimidine + bevacizumab) until time of tumor progression. Oxaliplatin may be reintroduced if it was discontinued previously for neurotoxicity rather than disease progression. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. lf cetuximab or panitumumab is used as initial therapy, then neither cetuximab nor panitumumab should be used in second or subsequent lines of therapy. There are insufficient data to guide the use of anti-EGFR therapy in the first-line setting with active chemotherapy based on BRAF V600E mutation status. Principles of pathologic review: -KRAS Mutation Testing: --Mutations in codons 12 and 13 in exon 2 of the coding region of the KRAS gene predict lack of response to therapy with antibodies targeted to the EGFRA. --Testing for mutations in codons 12 and 13 should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) as qualified to perform high complexity clinical laboratory (molecular pathology) testing. No specific methodology is recommended (eg, sequencing, hybridization). --The testing can be performed on formalin-fixed paraffin-embedded tissue. The testing can be performed on the primary colorectal cancers and/or the metastasis, as literature has shown that the KRAS mutations are similar in both specimen types. -BRAF Mutation Testing: --Patients with a V600E BRAF mutation appear to have a poorer prognosis. There are insufficient data to guide the use of anti-EGFR therapy in the first-line setting with active chemotherapy based on BRAF V600E mutation status. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a p…

DataPropertyAssertion
literal: Initial therapy. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1 Al. Guidelines for use in clinical practice have not been established. There is an increased risk of stroke and other arterial events, especially in those aged over 65 years. The use of bevacizumab may interfere with wound healing. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended.

DataPropertyAssertion
literal: Initial therapy. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. lf cetuximab or panitumumab is used as initial therapy, then neither cetuximab nor panitumumab should be used in second or subsequent lines of therapy. There are insufficient data to guide the use of anti-EGFR therapy in the first-line setting with active chemotherapy based on BRAF V600E mutation status. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1A1. Guidelines for use in clinical practice have not been established. Principles of pathologic review: -KRAS Mutation Testing: --Mutations in codons 12 and 13 in exon 2 of the coding region of the KRAS gene predict lack of response to therapy with antibodies targeted to the EGFRA. --Testing for mutations in codons 12 and 13 should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) as qualified to perform high complexity clinical laboratory (molecular pathology) testing. No specific methodology is recommended (eg, sequencing, hybridization). --The testing can be performed on formalin-fixed paraffin-embedded tissue. The testing can be performed on the primary colorectal cancers and/or the metastasis, as literature has shown that the KRAS mutations are similar in both specimen types. -BRAF Mutation Testing: --Patients with a V600E BRAF mutation appear to have a poorer prognosis. There are insufficient data to guide the use of anti-EGFR therapy in the first-line setting with active chemotherapy based on BRAF V600E mutation status. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy. --Testing for the BRAF V600E mutation can be performed on formalin-fixed paraffin-embedded tissues. T…

DataPropertyAssertion
literal: Initial therapy. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. lf cetuximab or panitumumab is used as initial therapy, then neither cetuximab nor panitumumab should be used in second or subsequent lines of therapy. There are insufficient data to guide the use of anti-EGFR therapy in the first-line setting with active chemotherapy based on BRAF V600E mutation status. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1A1. Guidelines for use in clinical practice have not been established. Principles of pathologic review: -KRAS Mutation Testing: --Mutations in codons 12 and 13 in exon 2 of the coding region of the KRAS gene predict lack of response to therapy with antibodies targeted to the EGFRA. --Testing for mutations in codons 12 and 13 should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) as qualified to perform high complexity clinical laboratory (molecular pathology) testing. No specific methodology is recommended (eg, sequencing, hybridization). --The testing can be performed on formalin-fixed paraffin-embedded tissue. The testing can be performed on the primary colorectal cancers and/or the metastasis, as literature has shown that the KRAS mutations are similar in both specimen types. -BRAF Mutation Testing: --Patients with a V600E BRAF mutation appear to have a poorer prognosis. There are insufficient data to guide the use of anti-EGFR therapy in the first-line setting with active chemotherapy based on BRAF V600E mutation status. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy. --Testing for the BRAF V600E mutation can be performed on formalin-fixed paraffin-embedded tissues. T…

DataPropertyAssertion
literal: Initial therapy lnfusional 5-FU is preferred. There is an increased risk of stroke and other arterial events, especially in those aged over 65 years. The use of bevacizumab may interfere with wound healing. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. A treatment option for patients not able to tolerate oxaliplatin or irinotecan.

DataPropertyAssertion
literal: Initial therapy Patients with diminished creatinine clearance may require dose modification of capecitabine. There is an increased risk of stroke and other arterial events, especially in those aged over 65 years. The use of bevacizumab may interfere with wound healing. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. A treatment option for patients not able to tolerate oxaliplatin or irinotecan.

DataPropertyAssertion
literal: Initial therapy. Data are not mature for the addition of biologic agents to FOLFOXIRI.

DataPropertyAssertion
literal: Therapy after first progression. There is an increased risk of stroke and other arterial events, especially in those aged more than 65 years. The use of bevacizumab may interfere with wound healing.

DataPropertyAssertion
literal: Therapy after first progression.lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1A1. Guidelines for use in clinical practice have not been established.

DataPropertyAssertion
literal: Therapy after first progression. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1A1. Guidelines for use in clinical practice have not been established.

DataPropertyAssertion
literal: Therapy after first progression. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1A1. Guidelines for use in clinical practice have not been established. There are no data to suggest activity of FOLFIRI-ziv-aflibercept in a patient who has progressed on FOLFIRI-bevacizumab, or vice versa. Ziv-aflibercept has only shown activity when given in conjunction with FOLFIRI in FOLFIRI-naive patients.

DataPropertyAssertion
literal: Therapy after first progression. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. Cetuximab is indicated in combination with innotecan-based therapy or as single-agent therapy for patients who cannot tolerate irinotecan. There are no data, nor is there a compelling rationale, to support the use of panitumumab after clinical failure on cetuximab, or the use of cetuximab after clinical failure on panitumumab. As such, the use of one of these agents after therapeutic failure on the other is not recommended. EGFR testing has no demonstrated predictive value; therefore, routine EGFR testing is not recommended. No patient should be included or excluded from cetuximab or panitumumab therapy on the basis of EGFR test results. Patients with a V600E BRAF mutation appear to have a poorer prognosis. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy. Principles of pathologic review: -KRAS Mutation Testing: --Mutations in codons 12 and 13 in exon 2 of the coding region of the KRAS gene predict lack of response to therapy with antibodies targeted to the EGFRA. --Testing for mutations in codons 12 and 13 should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) as qualified to perform high complexity clinical laboratory (molecular pathology) testing. No specific methodology is recommended (eg, sequencing, hybridization). --The testing can be performed on formalin-fixed paraffin-embedded tissue. The testing can be performed on the primary colorectal cancers and/or the metastasis, as literature has shown that the KRAS mutations are similar in both specimen types. -BRAF Mutation Testing: --Patients with a V600E BRAF mutation appear to have a poorer prognosis. There are insufficient data to guide the use of anti-EGFR therapy in the f…

DataPropertyAssertion
literal: Therapy after first progression. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. Cetuximab is indicated in combination with innotecan-based therapy or as single-agent therapy for patients who cannot tolerate irinotecan. There are no data, nor is there a compelling rationale, to support the use of panitumumab after clinical failure on cetuximab, or the use of cetuximab after clinical failure on panitumumab. As such, the use of one of these agents after therapeutic failure on the other is not recommended. EGFR testing has no demonstrated predictive value; therefore, routine EGFR testing is not recommended. No patient should be included or excluded from cetuximab or panitumumab therapy on the basis of EGFR test results. Patients with a V600E BRAF mutation appear to have a poorer prognosis. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy.

DataPropertyAssertion
literal: Therapy after first progression. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. Cetuximab is indicated in combination with innotecan-based therapy or as single-agent therapy for patients who cannot tolerate irinotecan. There are no data, nor is there a compelling rationale, to support the use of panitumumab after clinical failure on cetuximab, or the use of cetuximab after clinical failure on panitumumab. As such, the use of one of these agents after therapeutic failure on the other is not recommended. EGFR testing has no demonstrated predictive value; therefore, routine EGFR testing is not recommended. No patient should be included or excluded from cetuximab or panitumumab therapy on the basis of EGFR test results. Patients with a V600E BRAF mutation appear to have a poorer prognosis. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1 Al. Guidelines for use in clinical practice have not been established. Principles of pathologic review: -KRAS Mutation Testing: --Mutations in codons 12 and 13 in exon 2 of the coding region of the KRAS gene predict lack of response to therapy with antibodies targeted to the EGFRA. --Testing for mutations in codons 12 and 13 should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) as qualified to perform high complexity clinical laboratory (molecular pathology) testing. No specific methodology is recommended (eg, sequencing, hybridization). --The testing can be performed on formalin-fixed paraffin-embedded tissue. The testing can be performed on the primary colorectal cancers and/or the metastasis, as liter…

DataPropertyAssertion
literal: Procedure for positive findings of metachronous metastases.

DataPropertyAssertion
literal: Therapy after second progression For patients not able to tolerate the combination, consider single agent cetuximab or panitumumab. Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. Cetuximab is indicated in combination with innotecan-based therapy or as single-agent therapy for patients who cannot tolerate irinotecan. There are no data, nor is there a compelling rationale, to support the use of panitumumab after clinical failure on cetuximab, or the use of cetuximab after clinical failure on panitumumab. As such, the use of one of these agents after therapeutic failure on the other is not recommended. EGFR testing has no demonstrated predictive value; therefore, routine EGFR testing is not recommended. No patient should be included or excluded from cetuximab or panitumumab therapy on the basis of EGFR test results. Patients with a V600E BRAF mutation appear to have a poorer prognosis. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1 Al. Guidelines for use in clinical practice have not been established. Principles of pathologic review: -KRAS Mutation Testing: --Mutations in codons 12 and 13 in exon 2 of the coding region of the KRAS gene predict lack of response to therapy with antibodies targeted to the EGFRA. --Testing for mutations in codons 12 and 13 should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) as qualified to perform high complexity clinical laboratory (molecular pathology) testing. No specific methodology is recommended (eg, sequencing, hybridization). --The testing can be performed on formalin-fixed paraffin-embedded tis…

DataPropertyAssertion
literal: Therapy after second progression.

DataPropertyAssertion
literal: Therapy after second progression.

DataPropertyAssertion
literal: Therapy after second progression Conduct a research study of an innovative therapy for colon cancer.

DataPropertyAssertion
literal: Therapy after second progression. Single-agent or combination therapy with capecitabine, mitomycin, or gemcitabine has not been shown to be effective in this setting.

DataPropertyAssertion
literal: Therapy after third progression. Administer regorafenib if not given previously.

DataPropertyAssertion
literal: Therapy after first progression. Discontinuation of oxaliplatin should be strongly considered from FOLFOX or CapeOX after 3-4 months of therapy (or sooner if significant neurotoxicity develops higher than grade 2) with other drugs maintained (fluoropyrimidine + bevacizumab) until time of tumor progression. Oxaliplatin may be reintroduced if it was discontinued previously for neurotoxicity rather than disease progression. There are insufficient data to support the routine use of Ca/Mg infusion to prevent oxaliplatin-related neurotoxicity. There is an increased risk of stroke and other arterial events, especially in those aged over 65 years. The use of bevacizumab may interfere with wound healing.

DataPropertyAssertion
literal: Therapy after first progression. The majority of safety and efficacy data for this regimen have been developed in Europe, where a capecitabine starting dose of 1000 mg/m2 twice daily for 14 days, repeated every 21 days, is standard. Evidence suggests that North American patients may experience greater toxicity with capecitabine (as well as with other fluoropyrimidines) than European patients, and may require a lower dose of capecitabine. The relative efficacy of CapeOx with lower starting doses of capecitabine has not been addressed in large-scale randomized trials. There is an increased risk of stroke and other arterial events, especially in those aged over 65 years. The use of bevacizumab may interfere with wound healing.

DataPropertyAssertion
literal: Therapy after first progression. for patients not able to tolerate combination, consider single agent (cetuximab or panitumumab). Combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs is not recommended. Cetuximab is indicated in combination with innotecan-based therapy or as single-agent therapy for patients who cannot tolerate irinotecan. EGFR testing has no demonstrated predictive value; therefore, routine EGFR testing is not recommended. No patient should be included or excluded from cetuximab or panitumumab therapy on the basis of EGFR test results. There are no data, nor is there a compelling rationale, to support theuse of panitumumab after clinical failure on cetuximab, or the use of cetuximab after clinical failure on panitumumab. As such, the use of one of these agents after therapeutic failure on the other is not recommended. Patients with a V600E BRAF mutation appear to have a poorer prognosis. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1A1. Guidelines for use in clinical practice have not been established.

DataPropertyAssertion
literal: Therapy after second progression. Discontinuation of oxaliplatin should be strongly considered from FOLFOX or CapeOX after 3-4 months of therapy (or sooner if significant neurotoxicity develops higher than grade 2) with other drugs maintained (fluoropyrimidine + bevacizumab) until time of tumor progression. Oxaliplatin may be reintroduced if it was discontinued previously for neurotoxicity rather than disease progression. There are insufficient data to support the routine use of Ca/Mg infusion to prevent oxaliplatin-related neurotoxicity.

DataPropertyAssertion
literal: Consider PET-CT scan.

DataPropertyAssertion
literal: Therapy after second progression. The majority of safety and efficacy data for this regimen have been developed in Europe, where a capecitabine starting dose of 1000 mg/m2 twice daily for 14 days, repeated every 21 days, is standard. Evidence suggests that North American patients may experience greater toxicity with capecitabine (as well as with other fluoropyrimidines) than European patients, and may require a lower dose of capecitabine. The relative efficacy of CapeOx with lower starting doses of capecitabine has not been addressed in large-scale randomized trials.

DataPropertyAssertion
literal: Therapy after first progression. Discontinuation of oxaliplatin should be strongly considered from FOLFOX or CapeOX after 3-4 months of therapy (or sooner if significant neurotoxicity develops higher than grade 2) with other drugs maintained (fluoropyrimidine + bevacizumab) until time of tumor progression. Oxaliplatin may be reintroduced if it was discontinued previously for neurotoxicity rather than disease progression. There are insufficient data to support the routine use of Ca/Mg infusion to prevent oxaliplatin-related neurotoxicity. There is an increased risk of stroke and other arterial events, especially in those aged over 65 years. The use of bevacizumab may interfere with wound healing.

DataPropertyAssertion
literal: Therapy after first progression. The majority of safety and efficacy data for this regimen have been developed in Europe, where a capecitabine starting dose of 1000 mg/m2 twice daily for 14 days, repeated every 21 days, is standard. Evidence suggests that North American patients may experience greater toxicity with capecitabine (as well as with other fluoropyrimidines) than European patients, and may require a lower dose of capecitabine. The relative efficacy of CapeOx with lower starting doses of capecitabine has not been addressed in large-scale randomized trials. There is an increased risk of stroke and other arterial events, especially in those aged over 65 years. The use of bevacizumab may interfere with wound healing.

DataPropertyAssertion
literal: Therapy after first progression. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1A1. Guidelines for use in clinical practice have not been established.

DataPropertyAssertion
literal: Therapy after first progression. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1A1. Guidelines for use in clinical practice have not been established.

DataPropertyAssertion
literal: Therapy after first progression. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1A1. Guidelines for use in clinical practice have not been established.

DataPropertyAssertion
literal: Therapy after first progression. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1A1. Guidelines for use in clinical practice have not been established.

DataPropertyAssertion
literal: Therapy after first progression. lrinotecan should be used with caution and with decreased doses in patients with Gilbert’s disease or elevated serum bilirubin. There is a commercially available test for UGT1A1. Guidelines for use in clinical practice have not been established.

DataPropertyAssertion
literal: Therapy after first progression. There are no data to suggest activity of FOLFIRI-ziv-aflibercept in apatient who has progressed on FOLFIRI-bevacizumab, or vice versa. Ziv-aflibercept has only shown activity when given in conjunction with FOLFIRI in FOLFIRI-naive patients.

DataPropertyAssertion
literal: Therapy after second progression. Discontinuation of oxaliplatin should be strongly considered from FOLFOX or CapeOX after 3-4 months of therapy (or sooner if significant neurotoxicity develops higher than grade 2) with other drugs maintained (fluoropyrimidine + bevacizumab) until time of tumor progression. Oxaliplatin may be reintroduced if it was discontinued previously for neurotoxicity rather than disease progression. There are insufficient data to support the routine use of Ca/Mg infusion to prevent oxaliplatin-related neurotoxicity.

DataPropertyAssertion
literal: Treatment for resectable metastases.

DataPropertyAssertion
literal: Therapy after second progression. The majority of safety and efficacy data for this regimen have been developed in Europe, where a capecitabine starting dose of 1000 mg/m2 twice daily for 14 days, repeated every 21 days, is standard. Evidence suggests that North American patients may experience greater toxicity with capecitabine (as well as with other fluoropyrimidines) than European patients, and may require a lower dose of capecitabine. The relative efficacy of CapeOx with lower starting doses of capecitabine has not been addressed in large-scale randomized trials.

DataPropertyAssertion
literal: Initial therapy

DataPropertyAssertion
literal: Initial therapy. There are insufficient data to guide the use of anti-EGFR therapy in the first-line setting with active chemotherapy based on BRAF V600E mutation status. Principles of pathologic review: -KRAS Mutation Testing: --Mutations in codons 12 and 13 in exon 2 of the coding region of the KRAS gene predict lack of response to therapy with antibodies targeted to the EGFRA. --Testing for mutations in codons 12 and 13 should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) as qualified to perform high complexity clinical laboratory (molecular pathology) testing. No specific methodology is recommended (eg, sequencing, hybridization). --The testing can be performed on formalin-fixed paraffin-embedded tissue. The testing can be performed on the primary colorectal cancers and/or the metastasis, as literature has shown that the KRAS mutations are similar in both specimen types. -BRAF Mutation Testing: --Patients with a V600E BRAF mutation appear to have a poorer prognosis. There are insufficient data to guide the use of anti-EGFR therapy in the first-line setting with active chemotherapy based on BRAF V600E mutation status. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy. --Testing for the BRAF V600E mutation can be performed on formalin-fixed paraffin-embedded tissues. This is usually performed by amplification and direct DNA sequence analysis. Allele-specific PCR is another acceptable method for detecting BRAF V600E mutation. This testing should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) and qualified to perform high complexity clinical laboratory (molecular pathology) testing. -MSI Testing - See NCCN Guidelines for Colorectal Cancer Screening: --The panel recommends …

DataPropertyAssertion
literal: Initial therapy.

DataPropertyAssertion
literal: Initial therapy. There are insufficient data to guide the use of anti-EGFR therapy in the first-line setting with active chemotherapy based on BRAF V600E mutation status. Principles of pathologic review: -KRAS Mutation Testing: --Mutations in codons 12 and 13 in exon 2 of the coding region of the KRAS gene predict lack of response to therapy with antibodies targeted to the EGFRA. --Testing for mutations in codons 12 and 13 should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) as qualified to perform high complexity clinical laboratory (molecular pathology) testing. No specific methodology is recommended (eg, sequencing, hybridization). --The testing can be performed on formalin-fixed paraffin-embedded tissue. The testing can be performed on the primary colorectal cancers and/or the metastasis, as literature has shown that the KRAS mutations are similar in both specimen types. -BRAF Mutation Testing: --Patients with a V600E BRAF mutation appear to have a poorer prognosis. There are insufficient data to guide the use of anti-EGFR therapy in the first-line setting with active chemotherapy based on BRAF V600E mutation status. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy. --Testing for the BRAF V600E mutation can be performed on formalin-fixed paraffin-embedded tissues. This is usually performed by amplification and direct DNA sequence analysis. Allele-specific PCR is another acceptable method for detecting BRAF V600E mutation. This testing should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) and qualified to perform high complexity clinical laboratory (molecular pathology) testing. -MSI Testing - See NCCN Guidelines for Colorectal Cancer Screening: --The panel recommends …

DataPropertyAssertion
literal: See NCCN Guidelines for Palliative Care.

DataPropertyAssertion
literal: Procedure for improvement in functional status.

DataPropertyAssertion
literal: Medication recommendation for primary treatment.

DataPropertyAssertion
literal: Medication recommendation for primary treatment.

DataPropertyAssertion
literal: Medication recommendation for primary treatment.

DataPropertyAssertion
literal: Procedures for unresectable metachronous metastases.

DataPropertyAssertion
literal: Medication recommendation for primary treatment.

DataPropertyAssertion
literal: Medication recommendation for primary treatment.

DataPropertyAssertion
literal: Medication recommendation for primary treatment.

DataPropertyAssertion
literal: Medication recommendation for primary treatment.

DataPropertyAssertion
literal: Assessment of procedures for active chemotherapy regimen.

DataPropertyAssertion
literal: Resection for primary treatment. Hepatic artery infusion +/- 5-1FU/leucovori is also an option at institutions with experience in both the surgical and medical oncologic aspects of this procedure

DataPropertyAssertion
literal: invasive cancer

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: suspected or proven metastatic synchronous adenocarinoma

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: synchronous metastases

DataPropertyAssertion
literal: abdominal/peritoneal

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: metastases resectability

DataPropertyAssertion
literal: unresectable unconvertible

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: colon cancer

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: histologic features of polyp

DataPropertyAssertion
literal: favorable

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: polyp margins

DataPropertyAssertion
literal: clear

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: shape of polyps

DataPropertyAssertion
literal: pedunculated

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: shape of polyps

DataPropertyAssertion
literal: sessile

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: colon cancer appropriate for resection

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: tumor resectability

DataPropertyAssertion
literal: resectable

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: bowel obstruction

DataPropertyAssertion
literal: nonobstructing

DataPropertyAssertion
literal: string

DataPropertyAssertion
literal: suspected or proven metastatic synchronous adenocarcinoma

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: potentially surgically curable M1 disease

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: clinically indicated

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: colon cancer

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: KRAS mutated

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: tumor resectability

DataPropertyAssertion
literal: locally unresectable

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: medically inoperable

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: obstructing or imminently obstructing metastases

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: tumor resectability

DataPropertyAssertion
literal: resectable

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: bowel obstruction

DataPropertyAssertion
literal: obstructing

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: obstructing or imminenttly obstructing metastases

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Primary Tumor (T)

DataPropertyAssertion
literal: T1

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Regional Lymph Nodes (N)

DataPropertyAssertion
literal: N0

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: colon cancer

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Distant Metastasis (M)

DataPropertyAssertion
literal: M0

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Primary Tumor (T)

DataPropertyAssertion
literal: T2

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Primary Tumor (T)

DataPropertyAssertion
literal: Tis

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Primary Tumor (T)

DataPropertyAssertion
literal: T3

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: cancer high-risk features

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: cancer high-risk features

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Primary Tumor (T)

DataPropertyAssertion
literal: T4a

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Regional Lymph Nodes (N)

DataPropertyAssertion
literal: N1

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: shape of polyps

DataPropertyAssertion
literal: sessile

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Regional Lymph Nodes (N)

DataPropertyAssertion
literal: N2

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: advanced adenoma

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: advanced adenoma

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: synchronous metastases

DataPropertyAssertion
literal: liver and/or lung only

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: metastases resectability

DataPropertyAssertion
literal: resectable

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: metastases resectability

DataPropertyAssertion
literal: unresectable convertible

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: stage IV

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: imminent risk of obstruction

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: shape of polyps

DataPropertyAssertion
literal: pedunculated

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: significant bleeding

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: metastases converted to resectable

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: cancer recurrence

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: mutated KRAS gene

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: evidence of disease

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: regorafenib given previously

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: metastases converted to resectable

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: level of triglycerides

DataPropertyAssertion
literal: 150.0

DataPropertyAssertion
literal: mg/dL

DataPropertyAssertion
literal: type of polyp specimen

DataPropertyAssertion
literal: fragmented

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: level of fasting glucose

DataPropertyAssertion
literal: 110.0

DataPropertyAssertion
literal: mg/dL

DataPropertyAssertion
literal: waist circumference

DataPropertyAssertion
literal: 102.0

DataPropertyAssertion
literal: cm

DataPropertyAssertion
literal: level of triglycerides

DataPropertyAssertion
literal: 150.0

DataPropertyAssertion
literal: mg/dL

DataPropertyAssertion
literal: waist circumference

DataPropertyAssertion
literal: 102.0

DataPropertyAssertion
literal: cm

DataPropertyAssertion
literal: level of fasting glucose

DataPropertyAssertion
literal: 110.0

DataPropertyAssertion
literal: mg/dL

DataPropertyAssertion
literal: high cholesterol

DataPropertyAssertion
literal: CUI035

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Primary Tumor (T)

DataPropertyAssertion
literal: T4

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Regional Lymph Nodes (N)

DataPropertyAssertion
literal: N1a

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Regional Lymph Nodes (N)

DataPropertyAssertion
literal: N1

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Regional Lymph Nodes (N)

DataPropertyAssertion
literal: N1

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: polyp margins

DataPropertyAssertion
literal: cannot be assessed

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Regional Lymph Nodes (N)

DataPropertyAssertion
literal: N2

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Regional Lymph Nodes (N)

DataPropertyAssertion
literal: N2b

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: histologic features of polyp

DataPropertyAssertion
literal: unfavorable

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: type of polyp specimen

DataPropertyAssertion
literal: single

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: metachronous metastases

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: improvement in functional status

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: improvement in functional status

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: serial carcinoembryonic antigen (CEA) elevation

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: serial carcinoembryonic antigen (CEA) elevation

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: resectability of metachronous metastases

DataPropertyAssertion
literal: unresectable unconvertible

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: previous chemotherapy

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: previous chemotherapy

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: metachronous metastases

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: previous chemotherapy

DataPropertyAssertion
literal: adjuvant FOLFOX within past 12 months

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: previous chemotherapy

DataPropertyAssertion
literal: adjuvant FOLFOX >12 months ago

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: previous chemotherapy

DataPropertyAssertion
literal: previous 5-FU/LV or capecitabine

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: previous chemotherapy

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: metastases converted to resectable

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: patient appropriate for intensive therapy

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: patient appropriate for intensive therapy

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Conversion to resectability is a reasonable goal

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: resectability of metachronous metastases

DataPropertyAssertion
literal: resectable

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: resectability of metachronous metastases

DataPropertyAssertion
literal: unresectable convertible

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: tumor growth on neoadjuvant chemotherapy

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: tumor growth on neoadjuvant chemotherapy

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: Colonoscopy at 1 year: -If advanced adenoma, repeat in 1 year. -If no advanced adenoma (villous polyp, polyp bigger than 1 cm, or high-grade dysplasia), repeat in 3 years, then every 5 years.

DataPropertyAssertion
literal: Colonoscopy

DataPropertyAssertion
literal: -5-fluorouracil -leucovorin

DataPropertyAssertion
literal: -leucovorin 500 mg/m2 -5-fluorouracil 500 mg/m2

DataPropertyAssertion
literal: Principles of adjuvant therapy: -Capecitabine appears to be equivalent to bolus 5-FU/leucovorin in patients with stage Ill colon cancer. -FOLFOX is superior to fluoropyrimidine therapy alone for patients with stage Ill colon cancer. FOLFOX is reasonable for high-risk or intermediate-risk stage Il patients and is not indicated for good- or average-risk patients with stage Il colon cancer. FLOX is an alternative to FOLFOX. - Asurvival benefit has not been demonstrated for the addition of oxaliplatin to 5-FU/leucovonn in stage Il colon cancer. -A benefit for the addition of oxaliplatin to 5-FU/leucovorin in patients age 70 and older has not been proven. - Bolus 5-FU/leucovorin/innotecan should not be used in adjuvant therapy, and infusional 5-FU/leucovorin/innotecan (FOLFIRI) has not been shown to be superior to 5-FUlLy. Capecitabineloxaliplatin is superior to bolus 5-FUlleucovorin. -Bevacizumab, cetuximab, panitumumab, or innotecan should not be used in the adjuvant setting for patients with stage Il or Ill colon cancer outside the setting of a clinical trial.

DataPropertyAssertion
literal: 5-FU/leucovorin

DataPropertyAssertion
literal: lV

DataPropertyAssertion
literal: -leucovorin 500 mg/m2 given as a 2-hour infusion and repeated weekly x6 -5-fluorouracil 500 mg/m2 given bolus 1 hour after the start of leucovorin and repeated 6 x weekly

DataPropertyAssertion
literal: Computerized tomography (CT) to the chest, abdomen and pelvis. CT should be with IV and oral contrast. Consider abd/pelvic MRI with MRl contrast plus a non-contrast chest CT if either CT of abd/pelvis is inadequate or if patient has a contraindication to CT with IV contrast.

DataPropertyAssertion
literal: Computerized Tomography (CT)

DataPropertyAssertion
literal: Distinction between benign and malignant tumors. PET-CT does not supplant a contrast-enhanced diagnostic CT scan.

DataPropertyAssertion
literal: Positron Emission Tomography-Computer Tomography (PET-CT) scan

DataPropertyAssertion
literal: Colectomy: -Lymphadenectomy: --Lymph nodes at the origin of feeding vessel should be identified for pathologic exam. --Clinically positive lymph nodes outside the field of resection that are considered suspicious should be biopsied or removed, if possible. --Positive nodes left behind indicate an incomplete (R2) resection. --A minimum of 12 lymph nodes need to be examined to establish N stage. -Laparoscopic-assisted colectomy may be considered based upon the following criteria: -The surgeon has experience performing laparoscopically assisted colorectal operations. --There is no disease in the rectum or prohibitive abdominal adhesions. --There is no locally advanced disease. --It is not indicated for acute bowel obstruction or perforation from cancer. --Thorough abdominal exploration is required. --Consider preoperative marking of small lesions. -Management of patients with can-icr status of known or clinically suspected HNPCC. --Consider more extensive colectomy for patients with a strong family history of colon cancer or young age (<50 y). See NCCN Guidelines for Colorectal Cancer Screening -Resection needs to be complete to be considered curative.

DataPropertyAssertion
literal: One-Stage colectomy with en bloc removal of regional lymph nodes or resection with diversion.

DataPropertyAssertion
literal: Stent or Diversion.

DataPropertyAssertion
literal: Surgical procedures

DataPropertyAssertion
literal: -oxaliplatin -leucovorin -5-fluorouracil

DataPropertyAssertion
literal: -oxaliplatin 85 mg/m2 - leucovorin 400 mg/m2 IV over 2 hours, day I -5-fluorouracil 400 mg/m2 and afterwards 1200 mg/m2 day x 2 days (total 2400 mglm2 )

DataPropertyAssertion
literal: Principles of adjuvant therapy: -Capecitabine appears to be equivalent to bolus 5-FU/leucovorin in patients with stage Ill colon cancer. -FOLFOX is superior to fluoropyrimidine therapy alone for patients with stage Ill colon cancer. FOLFOX is reasonable for high-risk or intermediate-risk stage Il patients and is not indicated for good- or average-risk patients with stage Il colon cancer. FLOX is an alternative to FOLFOX. - Asurvival benefit has not been demonstrated for the addition of oxaliplatin to 5-FU/leucovonn in stage Il colon cancer. -A benefit for the addition of oxaliplatin to 5-FU/leucovorin in patients age 70 and older has not been proven. - Bolus 5-FU/leucovorin/innotecan should not be used in adjuvant therapy, and infusional 5-FU/leucovorin/innotecan (FOLFIRI) has not been shown to be superior to 5-FUlLy. Capecitabineloxaliplatin is superior to bolus 5-FUlleucovorin. -Bevacizumab, cetuximab, panitumumab, or innotecan should not be used in the adjuvant setting for patients with stage Il or Ill colon cancer outside the setting of a clinical trial. Consider Radiation Therapy orT4 with penetration to a fixed structure. See Principles of Radiation Therapy. Principles of Radiation Therapy: -Radiation therapy fields should include the tumor bed, which should be defined by preoperative radiological imaging and/or surgical clips. -Radiation doses should be 45-50 Gy in 25-28 fractions. --Consider boost for close or positive margins. --Small bowel dose should be limited to 45 Gy. --5-FU-based chemotherapy should be delivered concurrently with radiation. -If radiation therapy is to be used, conformal external beam radiation should be routinely used and intensity-modulated radiation therapy (IMRT) should be reserved only for unique clinical situations including re-irradiation of previously treated patients with recurrent disease. -Intraoperative radiation therapy (IORT), if available, should be considered for patients with T4 or recurrent cancers as an additional bo…

DataPropertyAssertion
literal: FOLFOX

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -oxaliplatin 85 mg/m2 IV over 2 hours on day 1 -leucovorin 400 mg/m2 IV over 2 hours on day 1 -5-fluorouracil 400 mg/m2 IV bolus on day 1, then 1200 mg/m2 day x 2 days (total 2400 mglm2 over 46-48 hours) IV continuous infusion

DataPropertyAssertion
literal: Use of a special needle to extract cells from the suspicious area for further testing, if clinically applicable.

DataPropertyAssertion
literal: Needle biopsy

DataPropertyAssertion
literal: Multidisciplinary team evaluation, including a surgeon experienced in the resection of hepatobiliary and lung metastases.

DataPropertyAssertion
literal: Multidisciplinary team evaluation

DataPropertyAssertion
literal: KRAS Mutation Testing: -Mutations in codons 12 and 13 in exon 2 of the coding region of the KRAS gene predict lack of response to therapy with antibodies targeted to the EG FR. -Testing for mutations in codons 12 and 13 should be performed only in laboratores that are certified under the dinical laboratory improvement amendments of 1988 (CLIA-88) as qualified to perform high complexity dinical laboratory (molecular pathology) testing. No specific methodology is recommended (eg, sequencing, hybridization). -The testing can be performed on formalin-fixed paraffin-embedded tissue. The testing can be performed on the primary colorectal cancers and/or the metastasis, as literature has shown that the KRAS mutations are similar in both specimen types. BRAF Mutation Testing: -Patients with a V600E BRAF mutation appear to have a poorer prognosis. There are insufficient data to guide the use of anti-EGFR therapy in the first-line setting with active chemotherapy based on BRAF V600E mutation status. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after a patient has progressed on first-line therapy. -Testing for the BRAF V600E mutation can be performed on formalin-flxed paraffin-embedded tissues. This Is usually performed by amplification and direct DNA sequence analysis. Allele-specific PCR is another acceptable method for detecting BRAF V600E mutation. This testing should be performed only in laboratories that are certified under the clinical laboratory improvement amendments of 1988 (CLIA-88) and qualified to perform high complexity clinical laboratory (molecular pathology) testing. MSI Testing - See NCCN Guidelines for Colorectal Cancer Screening: -The panel recommends that MMR protein testing be performed for all patients younger than 50 years with colon cancer, based on an increased likelihood of Lynch syndrome In this population. MMR testing should also be considered for all pat…

DataPropertyAssertion
literal: KRAS mutation test

DataPropertyAssertion
literal: testing for the BRAF V600E mutation performed on formalin-fixed paraffin-embedded tissues

DataPropertyAssertion
literal: BRAF mutation test

DataPropertyAssertion
literal: Confirm the presence of invasive cancer (pT1). pTis has no biological potential to metastasize. It has not been established if molecular markers are useful in treatment determination (predictive markers) and prognosis.

DataPropertyAssertion
literal: Pathology review

DataPropertyAssertion
literal: Criteria for Resectability of metastases and Locregional therapies within Surgery Liver Hepatic resection Is the treatment of choice for resectable liver metastases from colorectal cancer. Complete resection must be feasible based on anatomic grounds and the extent of disease; maintenance of adequate hepatic function is required. The primary tumor must have been resected for cure (RO). There should be no unresectable extrahepatic sites of disease. Having a plan for a debulking resection (less than an RO resection) is not recommended. Patients with resectable metastatic disease and a primary tumor In place should have both sites resected with curative intent. These can be resected in one operation or as a staged approach, depending on the complexity of the hepatectomy or colectomy, comorbid diseases, surgical exposure, and surgeon expertise. When hepatic metastatic disease is not optimally resectable based on insufficient remnant liver volume, approaches utilizing preoperative portal vein embolization or staged liver resection can be considered. Ablative techniques may be considered alone or in conjunction with resection. All original sites of disease need to be amenable to ablation or resection. Some institutions use arterially directed embolic therapy (category 3) in highly select patients with chemotherapy-resistant/-refractory disease, without obvious systemic disease, with predominant hepatic metastases. Conformal external beam radiation therapy (category 3) may be considered in highly selected cases or in the setting of a dinical trial and should not be used indiscriminately in patients who are potentially surgically resectable. Re-resection can be considered in selected patients. Lung Complete resection based on the anatomic location and extent of disease with maintenance of adequate function is required. The primary tumor must have been resected for cure (RO). Resectable extrapulmonary metastases do not preclude resection. Re-resection can be considered in se…

DataPropertyAssertion
literal: Colon resection or Diverting Colostomy or Bypass of impending obstruction or Stenting

DataPropertyAssertion
literal: -capecitabine

DataPropertyAssertion
literal: -capecitabine 125 mg/m2

DataPropertyAssertion
literal: Capecitabine is a prodrug that is enzymatically converted to 5-fluorouracil in the tumor, where it inhibits DNA synthesis and slows growth of tumor. Principles of adjuvant therapy: -Capecitabine appears to be equivalent to bolus 5-FU/leucovorin in patients with stage Ill colon cancer. -FOLFOX is superior to fluoropyrimidine therapy alone for patients with stage Ill colon cancer. FOLFOX is reasonable for high-risk or intermediate-risk stage Il patients and is not indicated for good- or average-risk patients with stage Il colon cancer. FLOX is an alternative to FOLFOX. - Asurvival benefit has not been demonstrated for the addition of oxaliplatin to 5-FU/leucovonn in stage Il colon cancer. -A benefit for the addition of oxaliplatin to 5-FU/leucovorin in patients age 70 and older has not been proven. - Bolus 5-FU/leucovorin/innotecan should not be used in adjuvant therapy, and infusional 5-FU/leucovorin/innotecan (FOLFIRI) has not been shown to be superior to 5-FUlLy. Capecitabineloxaliplatin is superior to bolus 5-FUlleucovorin. -Bevacizumab, cetuximab, panitumumab, or innotecan should not be used in the adjuvant setting for patients with stage Il or Ill colon cancer outside the setting of a clinical trial.

DataPropertyAssertion
literal: Capecitabine

DataPropertyAssertion
literal: -capecitabine 125 mg/m2 twice daily days 1-14

DataPropertyAssertion
literal: Redirect patient to clinical trial.

DataPropertyAssertion
literal: Clinical trial

DataPropertyAssertion
literal: Put the patient under surveillance.

DataPropertyAssertion
literal: Observation

DataPropertyAssertion
literal: -5-fluorouracil -leucovorin -oxaliplatin

DataPropertyAssertion
literal: -5-fluorouracil 500 mg/m2 -leucovorin 500 mg/m2 -oxaliplatin 85 mg/m2

DataPropertyAssertion
literal: Principles of adjuvant therapy: -Capecitabine appears to be equivalent to bolus 5-FU/leucovorin in patients with stage Ill colon cancer. -FOLFOX is superior to fluoropyrimidine therapy alone for patients with stage Ill colon cancer. FOLFOX is reasonable for high-risk or intermediate-risk stage Il patients and is not indicated for good- or average-risk patients with stage Il colon cancer. FLOX is an alternative to FOLFOX. - Asurvival benefit has not been demonstrated for the addition of oxaliplatin to 5-FU/leucovonn in stage Il colon cancer. -A benefit for the addition of oxaliplatin to 5-FU/leucovorin in patients age 70 and older has not been proven. - Bolus 5-FU/leucovorin/innotecan should not be used in adjuvant therapy, and infusional 5-FU/leucovorin/innotecan (FOLFIRI) has not been shown to be superior to 5-FUlLy. Capecitabineloxaliplatin is superior to bolus 5-FUlleucovorin. -Bevacizumab, cetuximab, panitumumab, or innotecan should not be used in the adjuvant setting for patients with stage Il or Ill colon cancer outside the setting of a clinical trial. Consider Radiation Therapy orT4 with penetration to a fixed structure. See Principles of Radiation Therapy. Principles of Radiation Therapy: -Radiation therapy fields should include the tumor bed, which should be defined by preoperative radiological imaging and/or surgical clips. -Radiation doses should be 45-50 Gy in 25-28 fractions. --Consider boost for close or positive margins. --Small bowel dose should be limited to 45 Gy. --5-FU-based chemotherapy should be delivered concurrently with radiation. -If radiation therapy is to be used, conformal external beam radiation should be routinely used and intensity-modulated radiation therapy (IMRT) should be reserved only for unique clinical situations including re-irradiation of previously treated patients with recurrent disease. -Intraoperative radiation therapy (IORT), if available, should be considered for patients with T4 or recurrent cancers as an additional bo…

DataPropertyAssertion
literal: FLOX

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -5-fluorouracil IV weekly x 6 -leucovorin IV 500 mglm2 weekly x 6, each 8-week cycle x 3 -oxaliplatin IV 85 mg/m2 on weeks 1, 3, and 5 of each 8-week cycle x 3

DataPropertyAssertion
literal: Preparation for the Surveillance procedures.

DataPropertyAssertion
literal: Surveillance

DataPropertyAssertion
literal: Obtain the patient's history and physical state.

DataPropertyAssertion
literal: History and physical

DataPropertyAssertion
literal: Inspection of the inside of the colon and rectum, using a colonoscope.

DataPropertyAssertion
literal: Colonoscopy

DataPropertyAssertion
literal: Procedure for Recurrence cancer

DataPropertyAssertion
literal: Recurrence

DataPropertyAssertion
literal: Carcinoembryonic antigen (CEA) test if patient is a candidate for further intervention.

DataPropertyAssertion
literal: CEA

DataPropertyAssertion
literal: Exam that views the inside of the colon (large intestine) and rectum, using a tool called a colonoscope. This examination should be performed in 1 year except if no preoperative colonoscopy due to obstructing lesion, otherwise the colonoscopy should be performed in 3-6 months.

DataPropertyAssertion
literal: Colonoscopy

DataPropertyAssertion
literal: Exam that views the inside of the colon (large intestine) and rectum, using a tool called a colonoscope.

DataPropertyAssertion
literal: Colonoscopy

DataPropertyAssertion
literal: Revision of the principles of survivorship.

DataPropertyAssertion
literal: Colorectal Cancer Surveillance: -Long-term surveillance should be carefully managed with routine good medical care and monitoring, including cancer screening, routine health care, and preventive care. -Routine CEA monitoring and routine CT scanning are not recommended beyond 5 years. Management of Late Sequelae of Disease or Treatment: -For chronic diarrhea or incontinence: --Consider anti-diarrheal agents, bulk-forming agents, diet manipulation, and protective undergarments. Prescription for Survivorship and Transfer of Care to Primary Care -Physician (If primary physician will be assuming cancer surveillance responsibilities): --Include overall summary of treatment, including all surgeries, radiation treatments, and chemotherapy received. --Describe possible clinical course, including expected time to resolution of acute toxicities, long-term effects of treatment, and possible late sequelae of treatment. --Include surveillance recommendations. --Delineate appropriate timing of transfer of care with specific responsibilities identified for primary care physician and oncologist. Cancer Screening Recommendations: -These recommendations are for average-risk patients: --Recommendations for high-risk individuals should be made on an individual basis. --Breast Cancer: See the NCCN Guidelines for Breast CancerScreening. --Cervical Cancer: See the NCCN Guidelines for Cervical Cancer Screening. --Prostate Cancer: See the NCCN Guidelines for Prostate Early Detection. Counseling Regarding Healthy Lifestyle and Wellness: -Maintain a healthy body weight throughout life. -Adopt a physically active lifestyle (At least 30 minutes of moderate intensity activity on most days of the week). Activity recommendations may require modification based on treatment sequelae (ie, ostomy, neuropathy). -Consume a healthy diet with emphasis on plant sources. -Limit alcohol consumption. -Receive smoking cessation counseling as appropriate. Additional health monitoring and immunizations should be …

DataPropertyAssertion
literal: Choice of the following procedures in Treatment 1.

DataPropertyAssertion
literal: Treatment 1

DataPropertyAssertion
literal: Procedure to acess the neoadjuvant theraphy action

DataPropertyAssertion
literal: Neoadjuvant therapy for 2-3 months.

DataPropertyAssertion
literal: -irinotecan -leucovorin -5-fluorouracil -bevacizumab

DataPropertyAssertion
literal: -irinotecan 180 mg/m2 -leucovorin 400 mg/m2 -5-fluorouracil 400 mg/m2, then 1299 mg/m2/day x 2 days (total of 2400 mg/m2) -bevacizumab 5 mg/kg

DataPropertyAssertion
literal: FOLFIRI +/- bevacizumab

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -irinotecan 180 mg/m2 IV over 30-90 minutes on day 1 -leucovorin 400 mg/m2 IV infusion to match duration of irinotecan infusion on day 1 -5-fluorouracil 400 mg/m2 IV bolus day 1, then 1200 mg/m2/day x 2 days (total 2400 mg/m2 over 46-48 hours) IV continuous infusion -bevacizumab 5 mg/kg IV on day 1

DataPropertyAssertion
literal: -oxaliplatin -leucovorin -5-fluorouracil -bevacizumab

DataPropertyAssertion
literal: -oxaliplatin 85 mg/m2 - leucovorin 400 mg/m2 -5-fluorouracil 400 mg/m2, then 1200 mg/m2/day x 2 days (total 2400 mg/m2) -bevacizumab 5 mg/kg

DataPropertyAssertion
literal: FOLFOX +/- bevacizumab

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -oxaliplatin mg/m2 IV over 2 hours on day 1 -leucovorin 400 mg/m2 IV over 2 hours on day 1 -5-fluorouracil 400 mg/m2 IV bolus on day 1, then 1200 mg/m2/day x 2 days (total 2400 mg/m2 over 46-48 hours) IV continuous infusion -bevacizumab 5 mg/kg IV on day 1

DataPropertyAssertion
literal: Injection of small amounts of sterile India ink or carbon black into the bowel wall during colonoscopy or within 2 weeks.

DataPropertyAssertion
literal: Marking of cancerous polyp site

DataPropertyAssertion
literal: -oxaliplatin -capecitabine -bevacizumab

DataPropertyAssertion
literal: -oxaliplatin 130 mg/m2 -capecitabine 850-1000 mg/m2 -bevacizumab 7.5 mg/kg

DataPropertyAssertion
literal: The majority of safety and efficacy data for this regimen have been developed in Europe, where a capecitabine starting dose of 1000 mg/m2 twice daily for 14 days, repeated every 21 days, is standard. Evidence suggests that North American patients may experience greater toxicity with capecitabine (as well as with other fluoropyrimidines) than European patients, and may require a lower dose of capecitabine. The relative efficacy of CapeOx with lower starting doses of capecitabine has not been addressed in large-scale randomized trials. The safety of administering bevacizumab pre- or postoperatively, in combination with 5-FU-based regimens, has not been adequately evaluated. There should be at least a 6-week interval between the last dose of bevacizumab and elective surgery and re-initiation of bevacizumab at least 6-8 weeks postoperatively. There is an increased risk of stroke and other arterial events, especially in those aged years. The use of bevacizumab may interfere with wound healing.

DataPropertyAssertion
literal: CapeOX +/- bevacizumab

DataPropertyAssertion
literal: IV and PO

DataPropertyAssertion
literal: -oxaliplatin 130 mg/m2 lV over2 hours on day 1 -capecitabine 850-1000 mg/m2 PO twice daily for 14 days -bevacizumab 7.5 mg/kg IV on day 1

DataPropertyAssertion
literal: -irinotecan -leucovorin -5-fluorouracil -cetuximab

DataPropertyAssertion
literal: -irinotecan 180 mg/m2 -leucovorin 400 mg/m2 -5-fluorouracil 400 mg/m2 , then 1200 mg/m2/day x 2 days (total 2400 mg/m2) -cetuximab 400 mg/m2 IV , then 250 mg/m2 IV or cetuximab 500 mg/m2

DataPropertyAssertion
literal: There are insufficient data to guide the use of anti-EGFR therapy in the first-line setting with active chemotherapy based on BRAF V600E mutation status.

DataPropertyAssertion
literal: FOLFIRI +/- cetuximab

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -irinotecan 180 mg/m2 IV over 30-90 minutes on day 1 -leucovorin 400 mg/m2 IV infusion to match duration of irinotecan infusion on day 1 -5-fluorouracil 400 mg/m2 IV bolus day 1, then 1200 mg/m2/day x 2 days (total 2400 mg/m2 over 46-48 hours) IV continuous infusion -cetuximab 400 mg/m2 IV over 2 hours first infusion, then 250 mg/m2 IV over 60 minutes weekly or cetuximab 500 mg/m2 IV over 2 hours, day 1, every 2 weeks

DataPropertyAssertion
literal: -oxaliplatin -leucovorin -5-fluorouracil -panitumumab

DataPropertyAssertion
literal: -oxaliplatin 85 mg/m2 -leucovorin 400 mg/m2 -5-fluorouracil 400 mg/m2, then 1200 mg/m2/day x 2 days(total 2400 mg/rn2) -panitumumab 6 mg/kg

DataPropertyAssertion
literal: FOLFOX +/- panitumumab

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -oxaliplatin 85 mg/m2 IV over 2 hours on day 1 -leucovorin 400 mg/m2 IV over 2 hours on day 1 -5-fluorouracil 400 mg/m2 IV bolus on day I, then 1200 mg/m2/day x 2 days (total 2400 mg/rn2 over 46-48 hours) IV continuous infusion -panitumumab 6 mg/kg IV over 60 minutes on day 1

DataPropertyAssertion
literal: -irinotecan -leucovorin -5-fluorouracil

DataPropertyAssertion
literal: -irinotecan 180 mg/m2 -leucovorin 400 mg/m2 -5-fluorouracil 400 mg/m2, then 1200 mg/m2/day x 2 days (total 2400 mg/m2)

DataPropertyAssertion
literal: FOLFORI

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -irinotecan 180 mg/m2 IV over 30-90 minutes on day 1 -leucovorin 400 mg/m2 IV infusion to match duration of irinotecan infusion on day 1 -5-fluorouracil 400 mg/m2 IV bolus day 1, then 1200 mg/m2/day x 2 days (total 2400 mg/m2 over 46-48 hours) continuous infusion

DataPropertyAssertion
literal: Incision (laparotomy) by means of laparoscopy, with resection of any part of the colon. Entails mobilization and ligation of the corresponding blood vessels. Hepatic artery infusion ± systemic 5-FU/Ieucovonn (category 2B) is also an option at institutions with experience in both the surgical and medical oncologic aspects of this procedure.

DataPropertyAssertion
literal: Synchronous or staged Colectomy

DataPropertyAssertion
literal: Resection of metastatic disease.

DataPropertyAssertion
literal: Resection

DataPropertyAssertion
literal: Incision (laparotomy) by means of laparoscopy, with resection of any part of the colon. Entails mobilization and ligation of the corresponding blood vessels. Hepatic artery infusion ± systemic 5-FU/Ieucovorin (category 2B) is also an option at institutions with experience in both the surgical and medical oncologic aspects of this procedure.

DataPropertyAssertion
literal: Colectomy

DataPropertyAssertion
literal: Procedure to acess the treatment action

DataPropertyAssertion
literal: Treatment 2

DataPropertyAssertion
literal: Choice of the best chemotherapy regimen.

DataPropertyAssertion
literal: Chemotherapy

DataPropertyAssertion
literal: Staged resection of metastatic disease.

DataPropertyAssertion
literal: Staged resection

DataPropertyAssertion
literal: Colectomy: -Lymphadenectomy: --Lymph nodes at the origin of feeding vessel should be identified for pathologic exam. --Clinically positive lymph nodes outside the field of resection that are considered suspicious should be biopsied or removed, if possible. --Positive nodes left behind indicate an incomplete (R2) resection. --A minimum of 12 lymph nodes need to be examined to establish N stage. -Laparoscopic-assisted colectomy may be considered based upon the following criteria: --The surgeon has experience performing laparoscopically assisted colorectal operations. --There is no disease in the rectum or prohibitive abdominal adhesions. --There is no locally advanced disease. --It is not indicated for acute bowel obstruction or perforation from cancer. --Thorough abdominal exploration is required. --Consider preoperative marking of small lesions. -Management of patients with can-icr status of known or clinically suspected HNPCC: --Consider more extensive colectomy for patients with a strong family history of colon cancer or young age (<50 y). See NCCN Guidelines for Colorectal Cancer Screening -Resection needs to be complete to be considered curative.

DataPropertyAssertion
literal: Colectomy with en bloc removal of regional lymph nodes

DataPropertyAssertion
literal: Incision (laparotomy) by means of laparoscopy, with synchronous or staged liver or lung resection. Entails mobilization and ligation of the corresponding blood vessels. Hepatic artery infusion ± systemic 5-FU/leucovorin (category 2B) is also an option at institutions with experience in both the surgical and medical oncologic aspects of this procedure.

DataPropertyAssertion
literal: Colectomy with synchronous or staged liver or lung resection.

DataPropertyAssertion
literal: Recommendations for adjuvant therapy

DataPropertyAssertion
literal: Consider observation or shortened course of chemotherapy.

DataPropertyAssertion
literal: Procedure to acess the Treatment 2 action

DataPropertyAssertion
literal: Treatment 2

DataPropertyAssertion
literal: Recommendations for systemic terapy.

DataPropertyAssertion
literal: Systemic theraphy

DataPropertyAssertion
literal: Recommendations for surveillance procedures.

DataPropertyAssertion
literal: Surveillance

DataPropertyAssertion
literal: -irinotecan -leucovorin -5-fluorouracil -panitumumab

DataPropertyAssertion
literal: -irinotecan 180 mg/m2 -leucovorin 400 mg/m2 -5-fluorouracil 400 mg/m2, then 1200 mg/m2/day x 2 days (total 2400 mg/m2) -panitumumab 6 mg/kg IV

DataPropertyAssertion
literal: FOLFIRI +/- panitumumab

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -irinotecan 180 mg/m2 IV over 30-90 minutes on day 1 -leucovorin 400 mg/m2 IV infusion to match duration of irinotecan infusion on day 1 -5-fluorouracil 400 mg/m2 IV bolus day 1, then 1200 mg/m2/day x 2 days (total 2400 mg/m2 over 46-48 hours) IV continuous infusion -panitumumab 6 mg/kg IV over 60 minutes on day 1

DataPropertyAssertion
literal: -irinotecan -oxaliplatin -leucovorin -fluorouracil

DataPropertyAssertion
literal: -irinotecan 165 mg/m2 -oxaliplatin 85 mg/m2 -leucovorin 400 mg/m2 -fluorouracil 1600 mg/m2/day x 2 days

DataPropertyAssertion
literal: FOLFOXIRI (category 2B)

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -irinotecan 165 mg/m2 IV on day 1 -oxaliplatin 85 mg/m2 on day 1 -leucovorin 400 mg/m2 on day 1 -fluorouracil 1600 mg/m2/day x 2 days (total 3200 mg/m2 over 48 hours) continuous infusion starting on day 1

DataPropertyAssertion
literal: Resection of any part of the colon entails mobilization and ligation of the corresponding blood vessels

DataPropertyAssertion
literal: Colon resection

DataPropertyAssertion
literal: Re-evaluate for conversion to resectable

DataPropertyAssertion
literal: Re-evaluate for conversion to resectable every two months if conversion to resectability is a reasonabe goal.

DataPropertyAssertion
literal: Observation may be considered, with the understanding that there is significantly greater incidence of adverse outcomes (residual disease, recurrent disease, mortality,hematogenous metastasis, but not lymph node metastasis) than polypoid malignant polyps. Endoscopically Removed Malignant Polyps: -A malignant polyp is defined as one with cancer invading through the musculans mucosae and into the submucosa (pT1). pTis is not considered a maIignant polyp. -Favorable histologic features: grade 1 or 2, no angiolymphatic invasion, and negative margin of resection. There is no consensus as to the definition of what constitutes a positive margin of resection. A positive margin has been defined as 1) tumor <1 mm from the transected margin, 2) tumor <2 mm from the transected margin, and 3) tumor cells present within the diathermy of the transected margin. -Unfavorable histologic features: grade 3 or4, angiolymphatic invasion, or a positive margin. See the positive margin definition above. -There is controversy as to whether malignant colorectal polyps with a sessile configuration can be successfully treated by endoscopic removal. The literature seems to indicate that endoscopically removed sessile malignant polyps have a significantly greater incidence of adverse outcomes (residual disease, recurrent disease, mortality, and heinatogenous metastasis, but not lymph node metastasis) than do polypoid malignant polyps. However, when one closely looks at the data, configuration by itself is not a significant variable for adverse outcome, and endoscopically removed malignant sessile polyps with grade I or lI histology, negative margins, and no lymphovascularinvasion can be successfully treated with endoscopic polypectomy.

DataPropertyAssertion
literal: Observation

DataPropertyAssertion
literal: Active chemotherapy regimen for advanced disease (category 2B) or if patient received neoadjuvant therapy, consider observation or shortened course of chemotherapy.

DataPropertyAssertion
literal: Adjuvant therapy

DataPropertyAssertion
literal: Synchronized or staged resection of colon and metastatic cancer.

DataPropertyAssertion
literal: Resection

DataPropertyAssertion
literal: Assessment of the Adjuvant therapy 1 procedures.

DataPropertyAssertion
literal: Adjuvant therapy 1

DataPropertyAssertion
literal: Assessment of the Adjuvant therapy 2 procedures.

DataPropertyAssertion
literal: Adjuvant therapy 2

DataPropertyAssertion
literal: Assessment of the Adjuvant therapy 3 procedures.

DataPropertyAssertion
literal: Adjuvant therapy 3

DataPropertyAssertion
literal: Preparation for workup procedures.

DataPropertyAssertion
literal: Workup1

DataPropertyAssertion
literal: Preparation for workup procedures.

DataPropertyAssertion
literal: Workup2

DataPropertyAssertion
literal: Preparation for workup procedures.

DataPropertyAssertion
literal: Workup3

DataPropertyAssertion
literal: -irinotecan -leucovorin -5-fluorouracil -ziv-aflibercept

DataPropertyAssertion
literal: -irinotecan 180 mg/m2 -leucovorin 400 mg/m2 -5-fluorouracil 400 mg/m2, then 1200 mg/m2/day x 2 days (total 2400 mg/m2) -ziv-aflibercept 4 mg/kg

DataPropertyAssertion
literal: FOLFIRI + ziv-aflibercept

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -Irinotecan 180 mg/m2 IV over 30-90 minutes on day 1 -leucovorin 400 mg/m2 IV infusion to match duration of irinotecan infusion on day 1 -5-FU 400 mg/m2 IV bolus day on day 1, then 1200 mg/m2/day x 2 days (total 2400 mg/m2 over 46-48 hours) continuous infusion -ziv-aflibercept 4 mg/kg IV

DataPropertyAssertion
literal: -irinotecan -bevacizumab

DataPropertyAssertion
literal: -irinotecan 125 mg/m2 or irinotecan 300-350 mg/m2

DataPropertyAssertion
literal: Irinotecan +/- bevacizumab

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -irinotecan 125 mg/m2 IV over 30-90 minutes on days 1 and 8 or irinotecan 300-350 mg/m2 IV over 30-90 minutes on day 1

DataPropertyAssertion
literal: -oxaliplatin -capecitabine

DataPropertyAssertion
literal: -oxaliplatin 130 mg/m2 -capecitabine 1000 mg/m2

DataPropertyAssertion
literal: Principles of adjuvant therapy: -Capecitabine appears to be equivalent to bolus 5-FU/leucovorin in patients with stage Ill colon cancer. -FOLFOX is superior to fluoropyrimidine therapy alone for patients with stage Ill colon cancer. FOLFOX is reasonable for high-risk or intermediate-risk stage Il patients and is not indicated for good- or average-risk patients with stage Il colon cancer. FLOX is an alternative to FOLFOX. - Asurvival benefit has not been demonstrated for the addition of oxaliplatin to 5-FU/leucovonn in stage Il colon cancer. -A benefit for the addition of oxaliplatin to 5-FU/leucovorin in patients age 70 and older has not been proven. - Bolus 5-FU/leucovorin/innotecan should not be used in adjuvant therapy, and infusional 5-FU/leucovorin/innotecan (FOLFIRI) has not been shown to be superior to 5-FUlLy. Capecitabineloxaliplatin is superior to bolus 5-FUlleucovorin. -Bevacizumab, cetuximab, panitumumab, or innotecan should not be used in the adjuvant setting for patients with stage Il or Ill colon cancer outside the setting of a clinical trial. Consider Radiation Therapy orT4 with penetration to a fixed structure. See Principles of Radiation Therapy. Principles of Radiation Therapy: -Radiation therapy fields should include the tumor bed, which should be defined by preoperative radiological imaging and/or surgical clips. -Radiation doses should be 45-50 Gy in 25-28 fractions. --Consider boost for close or positive margins. --Small bowel dose should be limited to 45 Gy. --5-FU-based chemotherapy should be delivered concurrently with radiation. -If radiation therapy is to be used, conformal external beam radiation should be routinely used and intensity-modulated radiation therapy (IMRT) should be reserved only for unique clinical situations including re-irradiation of previously treated patients with recurrent disease. -Intraoperative radiation therapy (IORT), if available, should be considered for patients with T4 or recurrent cancers as an additional bo…

DataPropertyAssertion
literal: CapeOX

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -oxaliplatin 130 mg/m2 over 2 hours in day 1 -capecitabine 1000 mg/m2 twice daily days 1-14

DataPropertyAssertion
literal: -irinotecan -ziv-aflibercept

DataPropertyAssertion
literal: -irinotecan 125 mg/m2 or irinotecan 300-350 mg/m2

DataPropertyAssertion
literal: Irinotecan +/- ziv-aflibercept

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -irinotecan 125 mg/m2 IV over 30-90 minutes on days 1 and 8 or irinotecan 300-350 mg/m2 IV over 30-90 minutes on day 1

DataPropertyAssertion
literal: -cetuximab -irinotecan

DataPropertyAssertion
literal: -cetuximab 400 mg/m2 or cetuximab 500 mg/m2 -irinotecan 300-350 mg/m2, or irinotecan 180 mg/m2 or irinotecan 125 mg/m2

DataPropertyAssertion
literal: Cetuximab + irinotecan

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -cetuximab 400 mg/m2 first infusion then 250 mg/m2 IV weekly or cetuximab 500 mg/m2 IV every 2 weeks -irinotecan 300-350 mg/m2 IV every 3 weeks or irinotecan 180 mg/m2 IV every 2 weeks or irinotecan 125 mg/m2 on days 1 and 8 and repeat every 3 weeks

DataPropertyAssertion
literal: -panitumumab 6 mg/kg IV -irinotecan 125 mg/m2 IV

DataPropertyAssertion
literal: -panitumumab 6 mg/kg IV over 60 minutes -irinotecan 125 mg/m2 or irinotecan 300-350 mg/m2

DataPropertyAssertion
literal: Panitumumab +/- irinotecan

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -panitumumab 6 mg/kg IV over 60 minutes every 2 weeks -irinotecan 125 mg/m2 IV over 30-90 minutes on days 1 and 8 every 3 weeks or irinotecan 300-350 mg/m2 IV over 30-90 minutes on day 1 every 3 weeks

DataPropertyAssertion
literal: -cetuximab -irinotecan

DataPropertyAssertion
literal: -cetuximab 400 mg/m2, then 250 mg/m2 or cetuximab 500 mg/m2 -irinotecan 125 mg/m2, or irinotecan 300-350 mg/m2 or irinotecan 125 mg/m2

DataPropertyAssertion
literal: Cetuximab +/- irinotecan

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -cetuximab 400 mg/m2 first infusion, then 250 mg/m2 IV weekly or cetuximab 500 mg/m2 every 2 weeks -irinotecan 125 mg/m2 on days 1 and 8 and repeat every 3 weeks, or irinotecan 300-350 mg/m2 IV every 3 weeks or irinotecan 180 mg/m2 IV every 2 weeks

DataPropertyAssertion
literal: -regorafenib

DataPropertyAssertion
literal: -regorafenib 160 mg

DataPropertyAssertion
literal: Regorafenib

DataPropertyAssertion
literal: PO

DataPropertyAssertion
literal: -regorafenib 160 mg PO daily days 1-21

DataPropertyAssertion
literal: not defined

DataPropertyAssertion
literal: Provide palliative care.

DataPropertyAssertion
literal: Best supportive care

DataPropertyAssertion
literal: -5-fluorouracil -leucovorin -bevacizumab

DataPropertyAssertion
literal: 5-FU/leucovorin +/- bevacizumab

DataPropertyAssertion
literal: -capecitabine -bevacizumab

DataPropertyAssertion
literal: -capecitabine 850-1250 mg/m2 P -bevacizumab 7.5 mg/kg

DataPropertyAssertion
literal: Capecitabine +/- bevacizumab

DataPropertyAssertion
literal: PO

DataPropertyAssertion
literal: -capecitabine 850-1250 mg/m2 PO twice daily, days 1-14 -bevacizumab 7.5 mg/kg IV on day 1

DataPropertyAssertion
literal: -irinotecan -oxaliplatin -bevacizumab

DataPropertyAssertion
literal: Irinotecan + oxaliplatin +/- bevacizumab

DataPropertyAssertion
literal: -leucovorin -5-fluorouracil

DataPropertyAssertion
literal: -leucovorin 500 mg/m2 -5-fluorouracil 500 mg/m2

DataPropertyAssertion
literal: Infusional 5-FU + leucovorin

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -leucovorin 500 mg/m2 IV over 2 hours, days 1, 8, 15, 22, 29, and 36 -5-fluorouracil 500 mg/m2 IV bolus 1 hour after start of leucovorin, days 1,8, 15, 22,29, and 36

DataPropertyAssertion
literal: Confirm the presence of non-metastatic cancer, review pathological stage and evaluate lymph nodes. Endoscopically Removed Malignant Polyps: -A malignant polyp is defined as one with cancer invading through the muscularis mucosae and into the submucosa (pT1). pTis is not considered a malignant polyp. -Favorable histologic features: grade 1 or 2, no angiolymphatic invasion, and negative margin of resection. There is no consensus as to the definition of what constitutes a positive margin of resection. A positive margin has been defined as 1) tumor <1mm from the transected margin, 2) tumor <2 mm from the transected margin, and 3) tumor cells present within the diathermy of the transected margin. -Unfavorable histologic features: grade 3 or4, angiolymphatic invasion, or a positive margin. See the positive margin definition above. -There is controversy as to whether malignant colorectal polyps with a sessile configuration can be successfully treated by endoscopicremoval. The literature seems to indicate that endoscopically removed sessile malignant polyps have a significantly greater incidence of adverse outcomes (residual disease, recurrent disease, mortality, and hematogenous metastasis, but not lymph node metastasis) than do polypoid malignant polyps. However, when one closely looks at the data, configuration by itself is not a significant variable for adverse outcome, and endoscopically removed malignant sessile polyps with grade I or Il histology, negative margins, and no lymphovascular invasion can be successfully treated with endoscopic polypectomy. Colon Cancer Appropriate for Resection: -Histologic confirmation of primary col onic malignant neoplasm. Pathological Stage: -The following parameters should be reported: --Grade of the cancer --Depth of penetration, (T) --Number of lymph nodes evaluated and number positive (N) --Status of proximal, distal, and radial margins --Lymphovascular invasion --Perineural invasion --Extranodal tumor deposits - Radial (circumfer…

DataPropertyAssertion
literal: Pathology review

DataPropertyAssertion
literal: -cetuximab

DataPropertyAssertion
literal: -cetuximab 400 mg/m2 , then 250 mg/m2 or cetuximab 500 mg/m2

DataPropertyAssertion
literal: Cetuximab

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -cetuximab 400 mg/m2 first infusion, then 250 mg/m2 IV weekly or cetuximab 500 mg/m2 IV over 2 hours, day 1

DataPropertyAssertion
literal: -capecitabine -bevacizumab

DataPropertyAssertion
literal: -capecitabine 850-1250 mg/m2 -bevacizumab 7.5 mg/kg

DataPropertyAssertion
literal: Capecitabine +/- bevacizumab

DataPropertyAssertion
literal: IV and PO

DataPropertyAssertion
literal: -capecitabine 850-1250 mg/m2 PO twice daily, days 1-14 -bevacizumab 7.5 mg/kg IV, day 1

DataPropertyAssertion
literal: -panitumumab

DataPropertyAssertion
literal: panitumumab 6 mg/kg

DataPropertyAssertion
literal: Panitumumab

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -panitumumab 6 mg/kg IV over 60 minutes

DataPropertyAssertion
literal: -irinotecan

DataPropertyAssertion
literal: -irinotecan 125 mg/m2 -irinotecan 300-350 mg/m2

DataPropertyAssertion
literal: Irinotecan

DataPropertyAssertion
literal: IV

DataPropertyAssertion
literal: -irinotecan 125 mg/m2 IV over 30-90 minutes, days 1 and 8 -irinotecan 300-350 mg/m2 IV over 30-90 minutes, day 1

DataPropertyAssertion
literal: Complete Blood Count (CBC), platelets, chemistry profile and Carcinoembryonic Antigen (CEA)

DataPropertyAssertion
literal: Blood tests

DataPropertyAssertion
literal: National Comprehensive Cancer Network

DataPropertyAssertion
literal: 2012-09-20T00:00:00

DataPropertyAssertion
literal: 2012-11-26T00:00:00

DataPropertyAssertion
literal: The NCCN Guidelines are a statement of evidence and consensus of the authors regarding their views of currently accepted approaches to colon cancer treatment.

DataPropertyAssertion
literal: NCC Clinical Practice Guidelines in Oncology: Colon Cancer

DataPropertyAssertion
literal: 3.2013

DataPropertyAssertion
literal: National Heart,Lung and Blood Institute

DataPropertyAssertion
literal: 2002-09-01T00:00:00

DataPropertyAssertion
literal: 2002-09-01T00:00:00

DataPropertyAssertion
literal: Recommendations for cholesterol testing and management. It focuses on the role of the clinical approach to prevention of coronary heart disease (CHD).

DataPropertyAssertion
literal: Detection of High Blood Cholesterol in Children and Adults

DataPropertyAssertion
literal: 1.0

DataPropertyAssertion
literal: Decision task to determine if a patient ha metabolic syndrome based on the values for triglycerides, waist circumference and fasting glucose.

DataPropertyAssertion
literal: 2.0

DataPropertyAssertion
literal: 6.0

DataPropertyAssertion
literal: 5.0

DataPropertyAssertion
literal: 2.0

DataPropertyAssertion
literal: 5.0

DataPropertyAssertion
literal: 5.0

DataPropertyAssertion
literal: 3.0

DataPropertyAssertion
literal: 2.0

DataPropertyAssertion
literal: 24.0

DataPropertyAssertion
literal: 3.0

DataPropertyAssertion
literal: 2.0

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The clinical pathway has ended. The guideline is complete.

DataPropertyAssertion
literal: The plan summarizes the NCCN clinical practice recommendations for managing colon cancer. It begins with the clinical presentation of the patient to the primary care physician or gastroenterologist. The plan adresses diagnosis, pathologic staging, surgical management, perioperative treatment, patient surveillance, management of recurrent and metastatic disease, and survivorship.

DataPropertyAssertion
literal: metabolic syndrome

DataPropertyAssertion
literal: CUI034

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: metabolic syndrome

DataPropertyAssertion
literal: CUI034

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: Description paramter 004

DataPropertyAssertion
literal: CUI003

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: invasive cancer

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI001

DataPropertyAssertion
literal: pedunculated

DataPropertyAssertion
literal: sessile

DataPropertyAssertion
literal: shape of polyps

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: Criteria for Resectability of metastases and Locoregional therapies within Surgery: -Liver: --Hepatic resection Is the treatment of choice for resectable liver metastases from colorectal cancer. --Complete resection must be feasible based on anatomic grounds and the extent of disease; maintenance of adequate hepatic function is required. --The primary tumor must have been resected for cure (RO). There should be no unresectable extrahepatic sites of disease. Having a plan for a debulking resection (less than an RO resection) is not recommended. --Patients with resectable metastatic disease and a primary tumor In place should have both sites resected with curative intent. These can be resected in one operation or as a staged approach, depending on the complexity of the hepatectomy or colectomy, comorbid diseases, surgical exposure, and surgeon expertise. --When hepatic metastatic disease is not optimally resectable based on insufficient remnant liver volume, approaches utilizing preoperative portal vein embolization or staged liver resection can be considered. --Ablative techniques may be considered alone or in conjunction with resection. All original sites of disease need to be amenable to ablation or resection. --Some institutions use arterially directed embolic therapy (category 3)in highly select patients with chemotherapy-resistant/-refractory disease, without obvious systemic disease, with predominant hepatic metastases. --Conformal external beam radiation therapy (category 3) may be considered in highly selected cases or in the setting of a dinical trial and should not be used indiscriminately in patients who are potentially surgically resectable. --Re-resection can be considered in selected patients. -Lung: --Complete resection based on the anatomic location and extent of disease with maintenance of adequate function is required. --The primary tumor must have been resected for cure (RO). --Resectable extrapulmonary metastases do not preclude resection. --Re-re…

DataPropertyAssertion
literal: CUI011

DataPropertyAssertion
literal: unresectable unconvertible

DataPropertyAssertion
literal: unresectable convertible

DataPropertyAssertion
literal: resectable

DataPropertyAssertion
literal: metastases resectability

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI012

DataPropertyAssertion
literal: liver and/or lung only

DataPropertyAssertion
literal: abdominal/peritoneal

DataPropertyAssertion
literal: synchronous metastases

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI013

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: obstructing or imminently obstructing metastases

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: Regional Lymph Nodes (N): -NX Regional lymph nodes cannot be assessed -N0 No regional lymph node metastasis -N1 Metastasis in 1-3 regional lymph nodes -N1a Metastasis in one regional lymph node -N1b Metastasis in 2-3 regional lymph nodes -N1c Tumor deposit(s) in the subserosa. mesentery, or nonpentonealized pericolic or perirectal tissues without regional nodal metastasis -N2 Metastasis in four or more regional lymph nodes -N2a Metastasis in 4-6 regional lymph nodes -N2b Metastasis in seven or more regional lymph nodes

DataPropertyAssertion
literal: CUI014

DataPropertyAssertion
literal: N0

DataPropertyAssertion
literal: N1

DataPropertyAssertion
literal: N2

DataPropertyAssertion
literal: Regional Lymph Nodes (N)

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: Primary Tumor (T): -TX Primary tumor cannot be assessed -T0 No evidence of primary tumor -Tis Carcinoma in situ: intraepithelial or invasion of lamina propria -T1 Tumor invades submucosa -T2 Tumor invades muscularis propria -T3 Tumor invades through the muscularis propria into the pencolorectal tissues -T4a Tumor penetrates to the surface of the visceral peritoneum b -T4b Tumor directly invades or is adherent to other organs or structures Tis indudes cancer cells confined within the glandular basement membrane (intraepithebal) a mucosal lanmina propria (intramucosal) with no extension through the muscularis mucosae into the submucosa. Direct invasion in T4 includes invasion of other organs or other segments of the colorectum as a result of direct extension through the serosa, as confirmed on microscopic examination (for example, invasion of the sigmoid colon by a carcinoma of the cecum) or, for cancers in a retropentoneal or subperitoneal location, direct invasion of other organs or structures by virtue of extension beyond the muscularis propria (i.e., respectively, a tumor on the posterior wall of the descending colon invading the left kidney or lateral abdominal wall; or a mid or distal rectal cancer with invasion of prostate, seminal vesicles, cervix. or vagina). A tumor that is adherent to other organs or structures, gossly, is dassified cT4b. However, if no tumor is present in the adhesion, microscopically, the classification should be pT1-4a depending on the anatomical depth of wall invasion. The V and L classifications should be used to identify the presence or absence of vascular or lymphatic invasion whereas the PN site-specific factor should be used for perineural invasion.

DataPropertyAssertion
literal: CUI015

DataPropertyAssertion
literal: T1

DataPropertyAssertion
literal: T4

DataPropertyAssertion
literal: T3

DataPropertyAssertion
literal: T2

DataPropertyAssertion
literal: Tis

DataPropertyAssertion
literal: Primary Tumor (T)

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: Distant Metastasis (M): -M0 No distant metastasis -M1 Distant metastasis -M1a Metastasis confined to one organ or site (eg. liver, lung, ovary, nonregional node) -M1b Metastases in more than one organ/site or the peritoneum

DataPropertyAssertion
literal: CUI016

DataPropertyAssertion
literal: M0

DataPropertyAssertion
literal: M1

DataPropertyAssertion
literal: Distant Metastasis (M)

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: High-risk factors for recurrence: poorly differentiated histology (exclusive of those cancers that are MSI-H), Iymphatic/vascular invasion, boweI obstruction, <12 lymph nodes examined, perineural invasion, localized perforation, or close, indeterminate, or positive margins. In high-risk stage II patients, there are no data that correlate risk features and selection of chemotherapy. Testing for mismatch repair (MMR) proteins should be considered d for all patients <50 years of age or with stage Il disease. Stage II M SI-H patients may have a good prognosis and do not benefit from 5-FU adjuvant therapy. Principles of risk assessment for stage II disease: -Patient/physidan discussion regarding the potential risks of therapy compared to potential benefits, including prognosis. This should indude discussion of evidence supporting treatment, assumptions of benefit from indirect evidence, morbidity associated with treatment, high-risk characteristics, and patient preferences. -When determining if adjuvant therapy should be administered, the following should be taken into consideration: --Number of lymph nodes analyzed after surgery (<12) --Poor prognostic features (eg, poorly differentiated histology [exclusive of those that are MSI-H]; lymphatic/vascular invasion; bowel obstruction; perineural invasion; localized perforation; close, indeterminate, or positive margins). --Assessment of other comorbidities and anticipated life expectancy. -The benefit of adjuvant chemotherapy does not improve survival by more than 5%. -The panel recommends that MMR protein testing be performed for all patients younger than 50 years with colon cancer, based on an increased likelihood of Lynch syndrome in this population. MMR testing should also be considered for all patients with stage Il disease, because stage Il MSI-H patients may have a good prognosis and do not benefit from 5-FU adjuvant therapy.

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: cancer high-risk features

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI019

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: metastases converted to resectable

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI002

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: colon cancer appropriate for resection

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI019

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: advanced adenocarcinoma

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: true

DataPropertyAssertion
literal: CUI030

DataPropertyAssertion
literal: waist circumference

DataPropertyAssertion
literal: cm

DataPropertyAssertion
literal: true

DataPropertyAssertion
literal: CUI031

DataPropertyAssertion
literal: level of triglycerides

DataPropertyAssertion
literal: mg/dL

DataPropertyAssertion
literal: true

DataPropertyAssertion
literal: CUI033

DataPropertyAssertion
literal: level of fasting glucose

DataPropertyAssertion
literal: mg/dL

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI004

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: suspected or proven metastatic synchronous adenocarcinoma

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: Endoscopically Removed Malignant Polyps: -A malignant polyp is defined as one with cancer invading through the musculans mucosae and into the submucosa (pT1). pTis is not considered a maIignant polyp. -Favorable histologic features: grade 1 or 2, no angiolymphatic invasion, and negative margin of resection. There is no consensus as to the definition of what constitutes a positive margin of resection. A positive margin has been defined as 1) tumor <1 mm from the transected margin, 2) tumor <2 mm from the transected margin, and 3) tumor cells present within the diathermy of the transected margin. -Unfavorable histologic features: grade 3 or4, angiolymphatic invasion, or a positive margin. See the positive margin definition above. -There is controversy as to whether malignant colorectal polyps with a sessile configuration can be successfully treated by endoscopicremoval. The literature seems to indicate that endoscopically removed sessile malignant polyps have a significantly greater incidence of adverse outcomes (residual disease, recurrent disease, mortality, and heinatogenous metastasis, but not lymph node metastasis) than do polypoid malignant polyps. However, when one closely looks at the data, configuration by itself is not a significant variable for adverse outcome, and endoscopically removed malignant sessile polyps with grade I or lI histology, negative margins, and no lymphovascularinvasion can be successfully treated with endoscopic polypectomy.

DataPropertyAssertion
literal: CUI005

DataPropertyAssertion
literal: favorable

DataPropertyAssertion
literal: unfavorable

DataPropertyAssertion
literal: histologic features of polyp

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI006

DataPropertyAssertion
literal: single

DataPropertyAssertion
literal: fragmented

DataPropertyAssertion
literal: type of polyp specimen

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI006

DataPropertyAssertion
literal: clear

DataPropertyAssertion
literal: impossible to assess

DataPropertyAssertion
literal: polyp margins

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI008

DataPropertyAssertion
literal: obstructing

DataPropertyAssertion
literal: nonobstructing

DataPropertyAssertion
literal: bowel obstruction

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI009

DataPropertyAssertion
literal: resectable

DataPropertyAssertion
literal: unresectable

DataPropertyAssertion
literal: locally unresectable

DataPropertyAssertion
literal: tumor resectability

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI010

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: medically inoperable

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI020

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: serial carcinoembryonic antigen (CEA) elevation

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI025

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: patient appropriate for intensive therapy

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI026

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: improvement on functional status

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI023

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: previous chemotherapy

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI024

DataPropertyAssertion
literal: previous 5-FU/LV or capecitabine

DataPropertyAssertion
literal: adjuvant FOLFOX >12 months

DataPropertyAssertion
literal: adjuvant FOLFOx within past 12 months

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: previous chemotherapy

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: Documented metachronous metastases by CT, MRI, and or biopsy

DataPropertyAssertion
literal: CUI021

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: metachronous metastases

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI022

DataPropertyAssertion
literal: unresectable unconvertible

DataPropertyAssertion
literal: unresectable convertible

DataPropertyAssertion
literal: resectable

DataPropertyAssertion
literal: resectability of metachronous metastases

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: false

DataPropertyAssertion
literal: CUI023

DataPropertyAssertion
literal: no

DataPropertyAssertion
literal: yes

DataPropertyAssertion
literal: tumor growth on neoadjuvant chemotherapy

DataPropertyAssertion
literal: null

DataPropertyAssertion
literal: 6.0

DataPropertyAssertion
literal: 3.0

DataPropertyAssertion
literal: 1.0

DataPropertyAssertion
literal: 1

DataPropertyAssertion
literal: 3.0

DataPropertyAssertion
literal: 1

DataPropertyAssertion
literal: 6.0

DataPropertyAssertion
literal: 3.0

DataPropertyAssertion
literal: 6.0

DataPropertyAssertion
literal: 3.0

DataPropertyAssertion
literal: 6.0

DataPropertyAssertion
literal: 3.0

DataPropertyAssertion
literal: 1.0

DataPropertyAssertion
literal: 12.0

DataPropertyAssertion
literal: 6.0

DataPropertyAssertion
literal: 2.0

DataPropertyAssertion
literal: 3.0

DataPropertyAssertion
literal: 8.0

DataPropertyAssertion
literal: 24

DataPropertyAssertion
literal: 3.0

DataPropertyAssertion
literal: 1

DataPropertyAssertion
literal: 3

DataPropertyAssertion
literal: 2.0

DataPropertyAssertion
literal: 28.0

DataPropertyAssertion
literal: 8.0

DataPropertyAssertion
literal: Chemotherapy for Advanced or Metastatic Disease.

DataPropertyAssertion
literal: Active chemotherapy regimen. Perioperative therapy should be considered for up to a total of 6 months.

DataPropertyAssertion
literal: Active chemotherapy regimen. Set of procedures for perioperative chemotherapy.

DataPropertyAssertion
literal: Set of procedures for perioperative chemotherapy. Perioperative therapy should be considered for up to a total of 6 months.

DataPropertyAssertion
literal: Neoadjuvant chemotherapy between 2-3 months. Primary treatment for patients who haven't previously undergone chemotherapy.

DataPropertyAssertion
literal: Neoadjuvant chemotherapy between 2 to 3 months. Primary treatment for patients who haven't previously undergone chemotherapy.

DataPropertyAssertion
literal: Active chemotherapy regimen. Perioperative therapy should be considered for up to a total of 6 months.

DataPropertyAssertion
literal: Chemotherapy for advanced or metastatic disease.

DataPropertyAssertion
literal: Chemotherapy for Advanced or Metastatic Disease

DataPropertyAssertion
literal: Procedures for the diagnostic and treatment of metabolic syndrome.

DataPropertyAssertion
literal: Set of exams to determine extent of recurrence.

DataPropertyAssertion
literal: Recurrence assessment.

DataPropertyAssertion
literal: Set of procedures for perioperative chemotherapy.

DataPropertyAssertion
literal: Chemotherapy regimen

DataPropertyAssertion
literal: Procedures for patients having metachronous metastases who did not previously undergo chemotherapy.

DataPropertyAssertion
literal: Primary treatment

DataPropertyAssertion
literal: Set of chemotherapy procedures for primary treatment.

DataPropertyAssertion
literal: Primary Treatment

DataPropertyAssertion
literal: Preparation for the most suitable chemotherapy regimen

DataPropertyAssertion
literal: Active chemotherapy regimen

DataPropertyAssertion
literal: Set of procedures for chemotherapy regimen 1. PET-CT should not be used to monitor progress of therapy. CT with contrast or MRI is recommended .

DataPropertyAssertion
literal: Chemotherapy regimen 1

DataPropertyAssertion
literal: Set of procedures for chemotherapy regimen 2. PET-CT should not be used to monitor progress of therapy. CT with contrast or MRI is recommended .

DataPropertyAssertion
literal: Chemotherapy regimend 1

DataPropertyAssertion
literal: Set of procedures for chemotherapy regimen 3. PET-CT should not be used to monitor progress of therapy. CT with contrast or MRI is recommended .

DataPropertyAssertion
literal: Chemotherapy regimen 3

DataPropertyAssertion
literal: Set of procedures for chemotherapy regimen 4. PET-CT should not be used to monitor progress of therapy. CT with contrast or MRI is recommended .

DataPropertyAssertion
literal: Chemotherapy regimen 4

DataPropertyAssertion
literal: Set of procedures for chemotherapy after first progression.

DataPropertyAssertion
literal: Therapy after first progression

DataPropertyAssertion
literal: See treatment for documented metachronous metastases.

DataPropertyAssertion
literal: Treatment for metachronous metastases

DataPropertyAssertion
literal: Set of procedures for chemotherapy after first or second second progression.

DataPropertyAssertion
literal: Therapy after first or second progression

DataPropertyAssertion
literal: Set of procedures for therapy after second or third progression.

DataPropertyAssertion
literal: Therapy after second or third progression

DataPropertyAssertion
literal: Set of procedures for chemotherapy after first progression.

DataPropertyAssertion
literal: Therapy after first progression.

DataPropertyAssertion
literal: Set of procedures for chemotherapy after second pprogression.

DataPropertyAssertion
literal: Therapy after second progression

DataPropertyAssertion
literal: Set of procedures for chemotherapy after second progression.

DataPropertyAssertion
literal: Therapy after second progression

DataPropertyAssertion
literal: Set of procedures for chemotherapy after first progression.

DataPropertyAssertion
literal: Therapy after first progression.

DataPropertyAssertion
literal: Set of procedures for chemotherapy after second progression.

DataPropertyAssertion
literal: Therapy after second progression.

DataPropertyAssertion
literal: Consider initial therapy.

DataPropertyAssertion
literal: Initial therapy.

DataPropertyAssertion
literal: Observation of growth on neoadjuvant chemotherapy.

DataPropertyAssertion
literal: Observation

DataPropertyAssertion
literal: Re-evaluate for conversion to resectable every 2 months if conversion to resectability is a reasonable goal.

DataPropertyAssertion
literal: Re-evaluation

DataPropertyAssertion
literal: See primary treatment for resectable metachronous metastases.

DataPropertyAssertion
literal: Primary treatment for resectable metachronous metastases.

DataPropertyAssertion
literal: Procedures for patients having metachronous metastases who did not previously undergo chemotherapy.

DataPropertyAssertion
literal: Primary treatment

DataPropertyAssertion
literal: Either continue with an active chemotherapy regimen or with FOLFOX.

DataPropertyAssertion
literal: Treatment for ungrown tumor.

DataPropertyAssertion
literal: Repeat neoadjuvant therapy.

DataPropertyAssertion
literal: Adjuvant therapy.

DataPropertyAssertion
literal: Either continue with an active chemotherapy regimen or with observation.

DataPropertyAssertion
literal: Treatment for grown tumor after neoadjuvant treatment.

DataPropertyAssertion
literal: The purpose of this question task is to determine the clinical presentation of the cancer. Small bowel and appendiceal adenocarcinoma may be treated with systemic chemotherapy according to the NCCN Guidelines for Colon Cancer. Peritoneal nesothelioma and other extrapleural mesotheliomas may be treated with systemic therapy along NCCN Guidelines for Pleural Mesothelioma. All patients with colon cancer should be counseled for family history and considered for risk assessment. Patients with suspected hereditary non-polyposis colon cancer (HNPCC), familial adenomatous polyposis (FAP), and attenuated FAR see the NCCN Guidelines for Colorectal Cancer Screening.

DataPropertyAssertion
literal: Characterization of cancerous polyps.

DataPropertyAssertion
literal: Unresectable metachronous metastases.

DataPropertyAssertion
literal: colon cancer

DataPropertyAssertion
literal: oncologists

DataPropertyAssertion
literal: patients with colon cancer

DataPropertyAssertion
literal: hypercholesterolemia

DataPropertyAssertion
literal: coronary heart disease

DataPropertyAssertion
literal: cardiologist

DataPropertyAssertion
literal: patients with high cholesterol

DataPropertyAssertion
literal: Procedure to direct the patient to a workup, given the clinical presentation of pedunculated or sessile polyps and invasive cancer.

DataPropertyAssertion
literal: Procedure to direct the patient to a workup, given the clinical presentation of non-metastatic colon cancer appropriate for ressection.

DataPropertyAssertion
literal: Procedure to direct the patient to a workup, given the clinical presentation of suspected or proven metastatic synchronous adenocarcinoma.

AnnotationAssertion
IRI: #End
literal: End

AnnotationAssertion
literal: ClinicalPracticeGuidelineProperty

AnnotationAssertion
IRI: #medicationRecommendationDescription
literal: medicationRecommendationDescription