Ann Coloproctol.
2023 Aug;39(4):307-314. 10.3393/ac.2022.00255.0036.
International Society of University Colon and Rectal Surgeons survey of surgeons’ preference on rectal cancer treatment
- Affiliations
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- 1Department of Abdominal and General Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania
- 2Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- 3Department of Surgery, University of Connecticut School of Medicine and Hartford Hospital, Hartford, CT, USA
- 4Department of Colorectal Surgery, National Cancer Center, National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- 5Department of Colorectal Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
- 6Department of Colorectal Surgery, King’s College Hospital Foundation NHS Trust, London, UK
- 7Department of Surgery, Klaipeda University Hospital, Klaipeda, Lithuania
- 8Health Research and Innovation Science Centre Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
- KMID: 2545301
- DOI: http://doi.org/10.3393/ac.2022.00255.0036
Abstract
- Purpose
Rectal cancer treatment has a wide range of possible approaches from radical extirpative surgery to nonoperative watchful waiting following chemoradiotherapy, with or without, additional chemotherapy. Our goal was to assess the personal opinion of active practicing surgeons on rectal cancer treatment if he/she was the patient.
Methods
A panel of the International Society of University Colon and Rectal Surgeons (ISUCRS) selected 10 questions that were included in a questionnaire that included other items including demographics. The questionnaire was distributed electronically to ISUCRS fellows and other surgeons included in our database and remained open from April 16 to 28, 2020.
Results
One hundred sixty-three specialists completed the survey. The majority of surgeons (n=65, 39.9%) chose the minimally invasive (laparoscopic) surgery for their personal treatment of rectal cancer. For low-lying rectal cancer T1 and T2, the treatment choice was standard chemoradiation+local excision (n=60, 36.8%) followed by local excision±chemoradiotherapy if needed (n=55, 33.7%). In regards to locally advanced low rectal cancer T3 or greater, the preference of the responders was for laparoscopic surgery (n=65, 39.9%). We found a statistically significant relationship between surgeons’ age and their preference for minimally invasive techniques demonstrating an age-based bias on senior surgeons’ inclination toward open approach.
Conclusion
Our survey reveals an age-based preference by surgeons for minimally invasive surgical techniques as well as organ-preserving techniques for personal treatment of treating rectal cancer. Only 1/4 of specialists do adhere to the international guidelines for treating early rectal cancer.
