Defining Benchmarks for Pelvic Exenteration Surgery: A Multicentre Analysis of Patients With Locally Advanced and Recurrent Rectal Cancers

Brown, KGM; Solomon, MJ; Koh, CE; Sutton, PA; Aguiar, S, Jr; Bezerra, TS; Clouston, HW; Desouza, A; Dozois, EJ; Ersryd, AL; Frizelle, F; Funder, JA; Garcia-Aguilar, J; Garfinkle, R; Glyn, T; Heriot, A; Kanemitsu, Y; Kong, CY; Kristensen, H&#216;; Malakorn, S; Mens, DM; Nilsson, PJ; Palmer, GJ; Pappou, E; Quinn, M; Quyn, AJ; Sahakitrungruang, C; Saklani, A; Solbakken, AM; Tiernan, JP; Verhoef, C; Steffens, D

Author(s): Brown, KGM; Solomon, MJ; Koh, CE; Sutton, PA; Aguiar, S, Jr; Bezerra, TS; Clouston, HW; Desouza, A; Dozois, EJ; Ersryd, AL; Frizelle, F; Funder, JA; Garcia-Aguilar, J; Garfinkle, R; Glyn, T; Heriot, A; Kanemitsu, Y; Kong, CY; Kristensen, HØ; Malakorn, S; Mens, DM; Nilsson, PJ; Palmer, GJ; Pappou, E; Quinn, M; Quyn, AJ; Sahakitrungruang, C; Saklani, A; Solbakken, AM; Tiernan, JP; Verhoef, C; Steffens, D;
Details: Publication Year 2025-12-01,Volume 282,Issue #6,Page 1118-1126
Journal Title: Annals of Surgery
Publication Type: Research article
Abstract: OBJECTIVE: To establish globally applicable benchmark outcomes for pelvic exenteration (PE) in patients with locally advanced primary rectal cancer (LARC) and locally recurrent rectal cancer (LRRC), using outcomes achieved at highly specialised centres. BACKGROUND: 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: Seven hundred sixty-three patients underwent PE, of which 464 patients (61%) had LARCs and 299 (39%) had LRRCs. Five hundred forty-four patients (71%) who met predefined lower-risk criteria formed the benchmark cohort. For patients with LARC, the calculated benchmark threshold for major complication rate was ≤44%; Comprehensive Complication Index: ≤30.2; 30-day mortality rate: 0%; 90-day mortality rate: ≤4.3%; R0 resection rate: ≥79%. For patients with LRRC, the calculated benchmark threshold for major complication rate was ≤53%; Comprehensive Complication Index: ≤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.
Publisher: Wolters Kluwer
Keywords: Humans; *Pelvic Exenteration/standards; *Benchmarking; Female; Retrospective Studies; Male; *Rectal Neoplasms/surgery/pathology/mortality; Middle Aged; Aged; *Neoplasm Recurrence, Local/surgery/pathology/mortality; Adult; Neoplasm Staging; Treatment Outcome; Aged, 80 and over; benchmarking; locally advanced rectal cancer; locally recurrent rectal cancer; pelvic exenteration; surgical outcomes
Department(s): Surgical Oncology
Publisher's Version: https://doi.org/10.1097/sla.0000000000006348
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-06-27 06:18:36

Last Modified: 2026-01-06 02:46:49