Current status of the approach to patients with rectal cancer in Latin America. Results of the CaReLa survey including 385 surgeons from 18 countries in the region.

Abstract

 Introduction: Multidisciplinary approach (MDT) in high-volume centers is the gold standard for treatment of patients with rectal cancer (RC). There are no population data in Latin America that reflect the approach to these patients in the region.

Aim: To carry out a survey including Latin American countries, covering different critical points in the management of patients with RC.

Materials and methods: During May/2022, surgeons from countries within the region were invited to complete a survey covering 3 points about the management of patients with RC: Annual volume of patients treated and complexity of the center, surgical technique, and availability of MDT and types of cancer treatment used. Participating surgeons were categorized according to the number of patients with rectal cancer treated at their institution (low -CBV-, medium -CMV- and high volume -CAV-).

Results: 385 responses to the survey were included in the analysis including centers from 18 Latin American countries: 100/210/75 from low, medium and high volume centers, respectively. CMV and CAV have a higher incidence of specialized surgeons in charge of patients with RC. 67.79% of the centers have access to minimally invasive techniques, this being more frequent in CMV and CAV. The use of neoadjuvant therapy in locally advanced tumors was 93.51%, with adherence to Watch & Wait protocols of 60.78%. CMV and CAV presented higher rates of multidisciplinary approach to patients. Finally, adherence to total neoadjuvant therapy and short-course radiotherapy strategies is low, with a higher prevalence in CMV and CAV.

Conclusions: This survey is the first to provide information on RC treatment in different centers and countries in Latin America. Future studies should analyze the impact of differences between centers on the outcome of treatment.