A Snapshot of the International Views of the Treatment of Rectal Cancer Patients, a Multi-regional Survey: International
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ORIGINAL SCIENTIFIC REPORT
A Snapshot of the International Views of the Treatment of Rectal Cancer Patients, a Multi-regional Survey: International Tendencies in Rectal Cancer Antonio Caycedo-Marulanda1,2,11 • Sunil V. Patel1 • Chris P. Verschoor2 • Johanna P. Uscategui3 Sami A. Chadi4 • Gabriela Moeslein5 • Manish Chand6 • Yasuko Maeda7 • John R. T. Monson8 • Steven D. Wexner9 • Julio Mayol10
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Accepted: 6 September 2020 Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background Management of rectal cancer has a number of potentially appropriate alternatives for each patient. Despite acceptance of standards, practices may vary among regions. There is significant paucity of data in this area. The objective was to create a snapshot of the regional differences. Design This online survey included 10 questions. Enquiries focused on controversial topics, on surgeon and hospital volume, surgical margins, appropriateness of surgical approaches and techniques, watch-and-wait strategies, and total neoadjuvant therapy. Major colorectal surgery societies around the world were asked to invite their members to complete the survey. Outcome Measures Frequency of responses across regions within each question was compared by Fisher’s exact test. Results Seven hundred and fifty-three participants from 60 countries responded. Eight regions were identified, and four had sufficient representation for comparisons. Similarities and differences in the therapies among these regions were identified. Robotic surgery penetrance is higher in North America, and watch and wait is more accepted in South America. Patients in Oceania are more likely to be diverted; Europe has more usage of taTME. Discussion This online survey was practical as a mean to provide a rapid assessment of the international picture on consistency and variability of rectal cancer patients’ care, and to potentially identify opportunities to standardized care to patients. Medical surveys have inherent limitations; pertinence to our study is selection bias. Conclusions The management of rectal cancer varies among different regions. Identification of differences is important when considering global efforts to improve management and interpret data.
This manuscript was accepted in abstract form for a Research Forum Podium Presentation during ASCRS’ Annual Scientific Meeting in Boston, MA, June 6–10, 2019: Quick Shots: Rectal Cancer. & Antonio Caycedo-Marulanda [email protected]
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Department of Surgery, University College London, London, UK
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Department of Colorectal Surgery, Western General Hospital, Edinburgh, Scotland, UK
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Center for Colon and Rectal Surgery, Digestive Health and Surgery Institute, AdventHealth Orlando, Orlando, USA
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Department of Surgery, Cleveland Clinic Florida, Weston, USA
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Department of Surgery, Queens University, Kingston, Canada
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Health Sciences North Research Institute, Sudbury, Canada
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Colorectal Surgery North, Sudbury, Canada
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Department of Surgery University Health Network (UHN), Toronto, Canada
Depa
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