SICCR Division of Oncology Meeting Report – Naples, Pascale Institute, March 5th 2010

On March 5^th the Division of Oncology of the SICCR had a meeting at the Pascale Institute of Naples.
The following people were present: Salvatore Pucciarelli, Giuseppe Casula, Giorgio Giannone. Paolo Del Rio, Emanuele DL Urso; Fabio Sgrana, Stefano Scabini, Arturo Lattunneddu were absent. The youngest member Dr EDL Urso acted as secretary.

During the meeting three different work policies were taken into consideration for the next biennium:
1. Divulgation
2. Network research
3. Clinical trials

1. Divulgation
The Division of Oncology would be responsible for implementing and managing with periodic updating the association’s web site regarding three aspects:

• Colorectal cancer Guidelines. The Division of Oncology undertakes to report (and not to build up de novo) the guidelines of the major international scientific associations, regarding colorectal cancer staging, treatment and follow up. It was proposed that a young surgeon with the supervision of the members of the Division of Oncology will prepare a summary of the document with a critical comment in order to publish it on the site. Dr Pucciarelli , with this aim, has proposed Dr Isacco Maretto
• Prospective Phase 3 Clinical Trial. The proposal was to point out and comment the abstract of all prospective randomized phase 3 clinical trial about the colorectal carcinoma. Dr Del Rio has offered to assume this responsibility and the members of the Division of Oncology have given their approval
• Colorectal cancer Syndromes. This is a topic that is not widespread among surgeons, even among colorectal surgeons. In this case too, a surgeon chosen by the members of the Division (Dr Urso) would be responsible for reporting the most important articles in this field and adding a comment

Prof. Casula has proposed the creation of an online consultancy service with the aim of discussing particular cases that any member of SICCR wishes to propose.
It was also propose a session during congresses dedicated to the discussion of clinical cases of particular complexity about both sporadic and hereditary tumors.
From a practical point of view, a limited number of clinical cases selected by the Division of Oncology could be discussed in a specific section of the site (Divulgation area). A member could suggest a case by inserting it in a predefined grid: an expert on the subject, chosen among the members of the Division or among dedicated specialists, will reply and chair the discussion.

2. Network research
Aim of this proposal is to create inside the Association a network of centers able to lead a research activity and to be equipped with means that will permit a real scientific collaboration among the various centers.
The means necessary to join this network are:

• A shared database (not necessarily the same for all the participants) which will permit to have available for a minimum of clinical and hystopathological data
• The possibility/will to create a biological database which can support studies of the Association
• The possibility to create a SICCR register of hereditary colorectal tumors or to concentrate about some particular aspects (eg. a register of attenuated polyposis).

It has been decided to send an email to the SICCR members before every event in order to know their liking and availability for the subjects chosen. The members of the Division are at disposition for those centers which do not have the necessary infrastructures and would like to create them. Thus is necessary to identify the centers which would like to become part of this research network.

3. Cooperative studies
Although this point includes some of the points mentioned in the previous section, it is distinctive because all members can participate to the cooperative studies, regardless of the fact that the single center is equipped with a database or a biological bank.
The Division of Oncology assumes the responsibility of promoting clinical studies in the field of oncology under the aegis of the SICCR. Obviously the Directive Council and the Trials committee must give their placet.
At present one of these studies is already started and concerns the reconstruction with J-pouch vs low colorectal anastomosis after low resection of the rectum for carcinoma. It is a prospective randomized study and the chairmen are: Prof. D. Nitti and Dr. S. Pucciarelli, Clinica Chirurgica II, Padova.
Dr. P. Del Rio has presented two clinical studies:

• Preoperative radiotherapy with 5 Gy/day for 5 days with an interval of 8 weeks before surgery and a PET 2 weeks from the end of the radiotherapy. Phase 1 and 2 observational study. Proposer: Chirurgia Oncologica, Istituto Pascale- Napoli
• ISAAC study: Chemotherapy vs surgery as primary approach to stage IV non radically operable and asymptomatic at diagnosis colorectal cancer. Randomized prospective study. English study with Italian supervisor, Dr. Romano, Istituto Pascale, Napoli.

The complete protocol of the studies proposed by the Division of Oncology will be published on the Association’s web site. The proposers of the single projects will give a periodic report of the their study. At the Association’s congress it would be appropriate to update the members about the progress of each study in fieri through a very short report exposed by each proposer or by a member of the division.

Dott. Salvatore Pucciarelli