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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2024年12月23日

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  • Avellaneda Nicolas,
  • Sebastian Valdivieso,
  • Fabio Leiro,
  • Marcos Gonzalez,
  • Marcelo Viola Malet,
  • Helio Moreira Junior,
  • Reinaldo Isaacs,
  • Eddy P. Licango-Naranjo,
  • Augusto Carrie,
  • Gianluca Pellino,
  • Spinelli Antonino,
  • Antonio Caycedo-Marulanda,
  • Mateo Santillán,
  • Delfina Berasategui,
  • Camila Bustamante Mayne,
  • Martina Brun,
  • Diana Alejandra Pantoja Pachajoa,
  • Matías Parodi,
  • Rosario Martiarena,
  • Sergio Schlain,
  • Camila Bras Harriott,
  • Nicolas Rotholtz,
  • Maximiliano Bun,
  • Analía Inés Potolicchio,
  • Yenny Quiroga,
  • Federico Héctor Enrique Carballo,
  • Pablo Farina,
  • Carlos Vaccaro,
  • Marcos González,
  • Simón Sedziszow,
  • Gaston Ortigueira,
  • Tomas Seip,
  • Oscar Dalzio Brosutti,
  • María Soledad Cian,
  • Fabio Oscar Leiro,
  • Romina Bianchi,
  • Julieta Yanet Espino Campagna,
  • Mariela Cedermas,
  • Pablo Arbios,
  • Agustín Alesandrini,
  • Juan Alberto Perriello,
  • Javier Ignacio Villaggi,
  • Florencia Barbero,
  • Juan Manuel Giordanino,
  • Gustavo Adrián Nari,
  • Juan Pablo Muñoz,
  • Natalia Mira Gesto,
  • Federico Medina,
  • Javier Santiago Minoldo,
  • Gerardo Zanoni,
  • Cristian Nicolas Lucas,
  • Debra Nielsen,
  • Juan Manuel Sotelo,
  • Ana Inés Leone,
  • Federico Posner,
  • Diego Hernán Barletta,
  • Christian Abel Ferrufino Méndez,
  • Rogerio Serafim Parra,
  • Fabio Lopes de Queiroz,
  • Daniel Mauricio Londoño Estrada,
  • Romulo Medeiros de Almeida,
  • João Batista de Sousa,
  • Bruno Augusto Alves Martins,
  • Marcela Maria Silvino Craveiro,
  • Rogerio Saad-Hossne,
  • Augusto Antonio Barrera Zamorano,
  • Alejandro Nicolas Barrera Escobar,
  • Claudio Patricio Benavides Yáñez,
  • Benedicto Misael Ocares Urzua,
  • Francisco Xavier Báez Rojas,
  • Tomas Sebastian Contreras Rivas,
  • Felipe Bellolio Roth,
  • Daniel Moreno Miranda,
  • Christophe Riquoir Altamirano,
  • Andrés Iglesias Bettini,
  • Nelson Niño Puentes,
  • María Sofia Labrador Morales,
  • Juan Camilo Correa Cote,
  • Gustavo Adolfo López,
  • Daniela Sierra Castaño,
  • Mauricio Gonzales Dorado,
  • Andrés Ramiro Lanza Diaz,
  • Víctor Hugo Bruno Cao,
  • Jessica Capre Pereira,
  • Rosana María Babilonia Yepes,
  • Cristina Judith Padilla Herrera,
  • Luis Eduardo Martínez López,
  • Maikel Adolfo Pacheco Trujillo,
  • Javier Ernesto Barreras González,
  • Jorge Gerardo Pereira Fraga,
  • Rafael Torres Peña,
  • Miguel Ángel Martínez Alfonso,
  • Silva Segovia David Renato,
  • Francisco David Rivadeneira Proaño,
  • Javier López-Gómez,
  • Aldo Hernán Jaramillo Romero,
  • Mario Alberto López Ramírez,
  • Pablo Zeron Pontones,
  • Ismael Brito Toledo,
  • Michel Hernández Valadez,
  • Adan Ramirez-Gaona,
  • Josue Palacio Magaña,
  • Roberto Ángel Núñez González,
  • Marisol Solórzano Vanegas,
  • María Alejandra Salazar Álvarez,
  • Carlos Alberto Medina Diarte,
  • Ruben Dominguez Azuaga,
  • María Alejandra Pequeño Martínez,
  • Marcelo Laurini Zanola,
  • Alejandro Soumastre,
  • Federico Duran,
  • Alexandra Duffau Furini,
  • Felix Luis Edgar Vásquez Chirinos,
  • Sergio Antonio Martínez-Millán,
  • Edibel Sabrina Vicent Vásquez,
  • Maryeli Josefina Solorzano Vásquez,
  • Marcelo Viola Malet

摘要

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.