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RACS ASC 2024

Exploring resectability in locally recurrent rectal cancer: current practice and perspectives from the PelvEx collaboration

Poster

Presentation Description

Institution: Royal Prince Alfred Hospital - NSW, Australia

Background Pelvic exenteration (PE) is now established as the treatment of choice in patients with advanced pelvic cancers. Despite significant progress in the field, there remains controversies and uncertainty in many aspects of PE. As PE is a low volume procedure, trials in this field have been challenging. The PelvEx collaborative (an international collaborative of PE specialists) has become instrumental in facilitating multi-centre studies to generate evidence for PE. PelvEx therefore represents the pinnacle organisation of PE expertise. A survey of PelvEx members was conducted to explore their views on disease resectability in PE. Methods A cross sectional study on PelvEx members using a purpose designed survey instrument was conducted. The instrument was developed by the authors with experience in PE. The survey comprised of different sections exploring surgeons’ experience and volume as well as respondents’ views on disease resectability. Categorical variables were compared using X2. Results 94 responses (of 115, 81.7%) were received. Of these, 78 (83%) were males. Most respondents were under 50 years old and have less than 10 years’ experience with PE. The median number of PE performed in the previous 12 months was 10 (IQR 5–20), with 26 (28%) respondents performing 20 or more PE per year. There was significant variability in respondents confidence with pelvic side wall dissection. The majority were uncomfortable with deep neurovascular resection in the pelvic side wall or major bony pelvis resection. Conclusion This survey of PelvEx specialists has significant variation in confidence level of PE specialists with deep side wall and high sacral resections. How this influences patient selection warrants further studying.

Speakers

Authors

Authors

Dr Philip Yang - , Associate Professor Cherry Koh - , Associate Profesor Daniel Steffens - , Mr Sascha Karunaratne - , Professor Michael Solomon -