Interpretation of the update points of colorectal and anal cancer in CACA guidelines (2025 edition)
10.3760/cma.j.cn441530-20250306-00087
- VernacularTitle:中国肿瘤整合诊疗指南（2025版）结直肠癌及肛管癌更新要点解读
- Author:
Zijing GUAN
1
;
Weiyuan ZHANG
1
;
Guiyu WANG
1
Author Information
1. 哈尔滨医科大学附属第二医院肿瘤中心 结直肠肿瘤外科，哈尔滨 150081
- Publication Type:Journal Article
- Keywords:
Colorectal neoplasms;
Anal canal carcinoma;
Guidelines;
Interpretation
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(6):693-699
- CountryChina
- Language:Chinese
-
Abstract:
The key points of the update of the content related to colorectal cancer and anal cancer in the Chinese Anti-Cancer Association (CACA) Guidelines for Integrative Oncology 2025 Edition (hereinafter referred to as the CACA 2025 Guidelines) include 4 aspects. In terms of epidemiology, the latest data on the incidence and mortality of colorectal cancer in China have been updated, and the recommended screening age has been adjusted. In diagnosis, the application of enhanced MRI examination in diagnosis has been optimized, and the recommendation for peripheral blood microsatellite instability (MSI) detection has been added. In terms of treatment, in surgical treatment, the total mesorectal excision of the right colon, the safety of the Natural Orifice Specimen Extraction Surgery (NOSES) technique, the applicable range of robotic surgery, and the high-level evidence-based medical evidence of transanal total mesorectal excision (taTME) have been newly added, and the principles of surgical treatment have been added as well. In medical treatment, the role of circulating tumor DNA (ctDNA) in treatment decision-making has been supplemented. The application of dual immunotherapy in advanced patients has been recommended, and the application of third-line and subsequent-line treatments in advanced patients has been newly added. The guidelines improved the principle of preoperative neoadjuvant radiotherapy for rectal cancer, changed the indication of short-course radiotherapy, and added a variety of chemoradiotherapy combinations and recommendations for the timing of surgery. In addition, the follow-up programs for colorectal cancer and anal canal cancer are clarified, and nutritional therapy, traditional Chinese medicine rehabilitation therapy and nursing care for sequelae are emphasized, which provide more scientific and comprehensive guidance for the diagnosis and treatment of colorectal cancer and anal canal cancer.
