A Snapshot of the International Views of the Treatment of Rectal Cancer Patients, a Multi-regional Survey: International Tendencies in Rectal Cancer
A Snapshot of the International Views of the Treatment of Rectal Cancer Patients, a Multi-regional Survey: International Tendencies in Rectal Cancer
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DOI：
10.1007/s00268-020-05795-6
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发表时间：
2020-10-08
影响因子：
2.6
通讯作者：
Mayol, Julio
中科院分区：
文献类型：
--
作者：
Caycedo-Marulanda, Antonio;Patel, Sunil, V;Mayol, Julio
背景直肠癌的治疗对每个患者都有许多潜在的合适的选择。尽管标准得到接受，但各区域的做法可能各不相同。这方面的数据非常缺乏。目的是对区域差异有一个大致的了解。设计本在线调查包括10个问题。调查集中在有争议的话题，外科医生和医院的数量，手术切缘，手术方法和技术的适当性，观察和等待策略，和总的新辅助治疗。世界各地的主要结直肠外科学会被要求邀请他们的成员完成调查。结果测量通过Fisher精确检验比较每个问题中不同地区的回答频率。结果来自60个国家的753名参与者做出了回应。确定了八个区域，其中四个区域具有足够的代表性，可供比较。确定了这些地区之间治疗的相似性和差异。机器人手术在北美的普及率更高，而在南美，观察和等待更容易被接受。大洋洲的患者更有可能被转移;欧洲对taTME的使用更多。讨论该在线调查是一种实用的手段，可以快速评估直肠癌患者护理的一致性和可变性的国际情况，并可能确定对患者进行标准化护理的机会。医学调查有其固有的局限性;我们的研究的相关性是选择偏差。结论不同地区直肠癌的治疗方法不同。在考虑全球努力改进管理和解释数据时，查明差异很重要。
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.