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    Defining benchmarks for pelvic exenteration surgery: a multicentre analysis of patients with locally advanced and recurrent rectal cancer

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    Authors
    Brown, K. G. M.
    Solomon, M. J.
    Koh, C. E.
    Sutton, Paul A
    Aguiar, S., Jr.
    Bezerra, T. S.
    Clouston, H. W.
    Desouza, A.
    Dozois, E. J.
    Ersryd, A. L.
    Frizelle, F.
    Funder, J. A.
    Garcia-Aguilar, J.
    Garfinkle, R.
    Glyn, T.
    Heriot, A.
    Kanemitsu, Y.
    Kong, C. Y.
    Kristensen, H.
    Malakorn, S.
    Mens, D. M.
    Nilsson, P. J.
    Palmer, G. J.
    Pappou, E.
    Quinn, M.
    Quyn, A. J.
    Sahakitrungruang, C.
    Saklani, A.
    Solbakken, A. M.
    Tiernan, J. P.
    Verhoef, C.
    Steffens, D.
    Show allShow less
    Affiliation
    Colorectal & Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Manchester, United Kingdom.
    Issue Date
    2024
    
    Metadata
    Show full item record
    Abstract
    OBJECTIVE: To establish globally applicable benchmark outcomes for pelvic exenteration (PE) in patients with locally advanced primary (LARC) and recurrent rectal cancer (LRRC), using outcomes achieved at highly specialised centres. BACKGROUND DATA: PE is established as the standard of care for selected patients with LARC and LRRC. There are currently no available benchmarks against which surgical performance in PE can be compared for audit and quality improvement. METHODS: This international multicentre retrospective cohort study included patients undergoing PE for LARC or LRRC at 16 highly experienced centres between 2018 and 2023. Ten outcome benchmarks were established in a lower-risk subgroup. Benchmarks were defined by the 75th percentile of the results achieved at the individual centres. RESULTS: 763 patients underwent PE, of which 464 patients (61%) had LARC and 299 (39%) had LRRC. 544 patients (71%) who met predefined lower risk criteria formed the benchmark cohort. For LARC patients, the calculated benchmark threshold for major complication rate was ≤44%; comprehensive complication index (CCI): ≤30.2; 30-day mortality rate: 0%; 90-day mortality rate: ≤4.3%; R0 resection rate: ≥79%. For LRRC patients, the calculated benchmark threshold for major complication rate was ≤53%; CCI: ≤34.1; 30-day mortality rate: 0%; 90-day mortality rate: ≤6%; R0 resection rate: ≥77%. CONCLUSIONS: The reported benchmarks for PE in patients with LARC and LRRC represent the best available care for this patient group globally and can be used for rigorous assessment of surgical quality and to facilitate quality improvement initiatives at international exenteration centres.
    Citation
    Brown KGM, Solomon MJ, Koh CE, Sutton PA, Aguiar S, Jr., Bezerra TS, et al. Defining Benchmarks for Pelvic Exenteration Surgery: A Multicentre Analysis of Patients with Locally Advanced and Recurrent Rectal Cancer. Ann Surg. 2024 May 15. PubMed PMID: 38747145. Epub 2024/05/15. eng.
    Journal
    Annals of Surgery
    URI
    http://hdl.handle.net/10541/626998
    DOI
    10.1097/sla.0000000000006348
    PubMed ID
    38747145
    Additional Links
    https://dx.doi.org/10.1097/sla.0000000000006348
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1097/sla.0000000000006348
    Scopus Count
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