eP512 - Organ Preservation Strategy for Rectal Cancer Patients Treated in the Community

ePoster Presenter(s)

• 

  Jetsen A. Rodriguez Silva, MD

  Resident
  University of South Florida Morsani College of Medicine
  University of South Florida Morsani College of Medicine
  Tampa, FL, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• AA

  Ashley Alden, D.O.

  Colorectal Surgery Research Fellow
  University of South Florida Morsani College of Medicine
  Tampa, Florida, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• TL

  Trenton Lippert, n/a

  Medical Student
  University of South Florida Morsani College of Medicine
  Tampa, Florida, United States

  Disclosure information not submitted.
• RS

  Reagan Sandstrom, n/a

  Medical Student
  University of South Florida Morsani College of Medicine
  Tampa, Florida, United States

  Disclosure information not submitted.
• SA

  Sabrina Awshah, n/a

  Medical Student
  University of South Florida Morsani College of Medicine
  Tampa, Florida, United States

  Disclosure information not submitted.
• RT

  Rishabh Thakkar, n/a

  Undergraduate Student
  University of South Florida Morsani College of Medicine
  Tampa, Florida, United States

  Disclosure information not submitted.
• 

  Jonathan R. Pastrana Del Valle, MD (he/him/his)

  Fellow in Colorectal Surgery
  University of South Florida
  University of South Florida - Morsani College of Medicine
  Tampa, FL, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• CM

  Carolina Martinez, M.D.

  Assistant Professor
  University of South Florida Morsani College of Medicine
  Tampa, Florida, United States

  Disclosure information not submitted.
• AC

  Allen P. Chudzinski, M.D.

  Professor of Surgery
  University of South Florida Morsani College of Medicine
  Tampa, Florida, United States

  Disclosure information not submitted.
• RB

  Robert D. Bennett, MD

  Assistant Professor of Surgery,
  University of South Florida
  Tampa, Florida, United States

  Disclosure information not submitted.

Senior Author(s)

• JM

  Jorge Marcet, MD

  Professor, Department of Surgery
  Morsani College of Medicine, University of South Florida
  Tampa, Florida, United States

  Disclosure information not submitted.

Purpose/Background: Traditional surgical management of rectal cancer has been associated with significant postoperative complications and reduced quality of life. The organ preservation strategy, focusing on total neoadjuvant therapy (TNT), emerges as a promising alternative. This study aimed to determine the 3-year disease-free and surgery-free survival rates in community-treated patients.Methods/Interventions: A retrospective review of an academic institutional rectal cancer database was conducted. This database includes a large number of patients who are managed by academic colorectal surgeons and community-based medical and radiation oncologists. Sixty-six patients with rectal cancer managed by medical/radiation oncologists outside of our academic institution were initially classified as organ preservation strategy between July 2014 and January 2021. After excluding 14 due to clinical trial participation, 52 were analyzed. Kaplan-Meier analysis was used for survival estimation.Results/Outcomes: The average age at diagnosis was 61.77 years (mean ± SD: 61.77 ± 11.66), with 59.6% male patients. The majority (88.5%) identified as White or Caucasian (Not Hispanic or Latino). All patients received TNT consisting of neoadjuvant chemoradiotherapy or short-course radiation with induction or consolidation chemotherapy (Table 1). Forty patients (77%) demonstrated a complete clinical response to TNT, while 9 (17%) had a near-complete clinical response. The 3-year disease-free survival rate was determined to be 65.4%. The surgery-free survival rate over the same period was 73.1%.Conclusion/

Discussion: Patients managed outside clinical trial protocols demonstrated favorable 3-year outcomes using an organ preservation strategy. This approach could be an effective alternative to standard procedures, minimizing associated surgical morbidities. These findings underline the potential advantages of this approach, indicating its broader applicability in community or hybrid (academic/community) settings where the appropriate expertise is available, and highlight the need for further studies outside of purely academic settings to validate these findings."Table 1. Distribution of Clinical Stages and Neoadjuvant Treatments in Rectal Cancer Patients

Table 2. Recurrence Patterns and Duration to Event in Rectal Cancer Patients

NAT=Neoadjuvant Therapy"