Short-term surgical outcomes of rectal adenocarcinoma surgical treatment in Latin America: a multicenter, retrospective assessment in 49 centers from 12 countries

Viola Malet, Marcelo - LATAM collaborative colorectal surgery consortium, Autor corporativo

Resumen:

Introduction: Rectal cancer is a prevalent disease that requires multidisciplinary management. Results of treatment of patients suffering from this malignancy in Latin America have been scarcely reported before. Methods: A retrospective, multicenter study was conducted to report preoperative and operative characteristics of patients intervened for rectal cancer in centers from Latin America during 2015-2022, and the short-term results of treatment were analyzed. The study was open to any center receiving rectal cancer patients, irrespective of volume. The main study outcome was 30-day postoperative complications including any deviation from the normal postoperative course (Clavien Dindo I to V). Results: A total of 2044 patients from 49 centers in 12 Latin American countries were included, with a mean age of 63 years. Twenty-five percent of patients were operated in low-volume centers. Twenty-nine percent of patients had a tumor located in the low rectum, and only 53% of patients had preoperative MRI for local staging. A total of 1052 patients (52%) received neoadjuvant therapy before surgery. Eighty-six percent of patients were operated by a specialized colorectal surgeon, and 31% of patients were intervened using a conventional approach. A total of 29.9% of patients presented a postoperative complication. The anastomotic leak rate was 8.9%. Fifty-eight percent of pathology reports had less than 12 lymph nodes harvested, and 22.9% of reports did not include mesorectal quality. In the multivariate analysis, neoadjuvant therapy (OR: 1.44, p-value: 0.023), urgent procedures (OR: 3.73, p-value: 0.049), intraoperative complications (OR: 2.21, p-value: 0.046), advanced tumors (OR: 1.39, p-value: 0.036), and prolonged surgery (OR: 1.74, p-value: 0.004) were found to be independently related to suffering postoperative complications. Conclusions: This study includes information about the approach and results of rectal cancer management in Latin America at a large scale. In the future, this information can be used as a bridge to identify areas of improvement among rectal cancer patients' treatment in the region.

Detalles Bibliográficos
2024
Cancer
Latin America
Multidisciplinary
Neoadjuvant
Rectal
ADENOCARCINOMA
PATOLOGÍA
PERSONA DE MEDIANA EDAD
ANCIANO
CIRUGÍA GENERAL
HUMANOS
EPIDEMIOLOGÍA
COMPLICACIONES POSOPERATORIAS
NEOPLASIAS DEL RECTO
ESTUDIOS RETROSPECTIVOS
FACTORES DE TIEMPO
RESULTADO DEL TRATAMIENTO
Inglés
Universidad de la República
COLIBRI
https://hdl.handle.net/20.500.12008/56321
Acceso abierto
Licencia Creative Commons Atribución (CC - By 4.0)