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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

2024; Springer Science+Business Media; Volume: 39; Issue: 1 Linguagem: Inglês

10.1007/s00384-024-04763-z

1432-1262

Nicolás Avellaneda, Sebastian Valdivieso, Fabio Leiro, Marcos González, Marcelo Viola, Helio Moreira, Reinaldo Isaacs Beron, Eddy P. Licango-Naranjo, Augusto Carrie, Gianluca Pellino, Antonino Spinelli, Antonio Caycedo-Marulanda, Mateo Santillán, Delfina Berasategui, C. J. Mayne, M. Brun, Diana Alejandra Pantoja Pachajoa, Matías Parodi, Rosario Martiarena, Sergio Schlain, Camila Bras Harriott, Nicolás A. Rotholtz, Maximiliano Bun, Analia Potolicchio, Yenny Quiroga, Federico Carballo, P Farina, Carlos Vaccaro, Marcos González, Simón Sedziszow, Gaston Ortigueira, T. Seip, Oscar D Brosutti, María Soledad Cian, Fabio O. Leiro, Romina Bianchi, Julieta Yanet Espino Campagna, Mariela Cedermas, Pablo Arbios, Agustín Alesandrini, Juan Perriello, Javier Ignacio Villaggi, F Reinoso Barbero, Juan Manuel Giordanino, Gustavo Nari, Juan Pablo Flórez Muñoz, Natalia Mira Gesto, Federico Medina, Javier Santiago Minoldo, G. Zanoni, C. Lucas, D.L. Nielsen, Juan Manuel Sotelo, Alvaro Leone, Federico Posner, D. Barletta, Christian Méndez, Rogerio Serafim Parra, Fábio Lopes de Queiroz, Daniel Maurício Londoño Estrada, Rômulo Medeiros de Almeida, João Batista de Sousa, Bruno Augusto Alves Martins, Marcela Maria Silvino Craveiro, Rogério Saad-Hossne, A. Zamorano, Alejandro Escobar, Carlos Yáñez, Benedicto Misael Ocares Urzua, Francisco Xavier Báez Rojas, T. Rivas, Felipe Bellolio Roth, Daniel Miranda, Christophe Riquoir Altamirano, Andrés Iglesias Bettini, Nelson Niño Puentes, Mònica Morales, Juan Camilo Correa Cote, Gustavo A. Yepes López, Daniela Sierra Castaño, M Dorado, A. Díaz, V. Cao, José Carlos Pereira, Rosana María Babilonia Yepes, Cristina Judith Padilla Herrera, Laura Svidler López, Maikel Pacheco, Javier Ernesto Barreras González, Jorge Gerardo Pereira Fraga, Rafael Torres Peña, Miguel Ángel Martínez Alfonso, Renato Salvador, Francisco David Rivadeneira Proaño, Javier López-Gómez, Almudena Layos-Romero, Mario Alberto López Ramírez, Pablo Zeron Pontones, Ismael Brito Toledo, Michel Hernández Valadez, Adan Ramirez-Gaona, Japhet Magana, Raquel Estévez González, Marcela Vanegas, María Álvarez, Carlos Alberto Medina Diarte, Ruben Dominguez Azuaga, M. Martinez, Marcelo Laurini Zanola, Alejandro Soumastre, Federico Durán, Alexandra Duffau Furini, F. Chirinos, Sergio Antonio Martínez-Millán, Eva M. Vasquez, Mario Ferrer Vasquez, Marcelo Viola,

Colorectal Cancer Screening and Detection

Abstract 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.