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A nationwide audit of the use of radiotherapy for rectal cancer in Italy

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Abstract

Background

There is good evidence that radiotherapy is beneficial in advanced rectal cancer, but its application in Italy has not been investigated.

Methods

We conducted a nationwide survey among members of the Italian Society of Colo-Rectal Surgery (SICCR) on the use of radiation therapy for rectal cancer in the year 2005. Demographic, clinical and pathologic data were retrospectively collected with an online database. Italy was geographically divided into 3 regions: north, center and south which included the islands. Hospitals performing 30 or more surgeries per year were considered high volume. Factors related to radiotherapy delivery were identified with multivariate analysis.

Results

Of 108 centers, 44 (41%) responded to the audit. We collected data on 682 rectal cancer patients corresponding to 58% of rectal cancers operated by SICCR members in 2005. Radiotherapy was used in 307/682 (45.0%) patients. Preoperative radiotherapy was used in 236/682 (34.6%), postoperative radiotherapy in 71/682 (10.4%) cases and no radiotherapy in 375 (55.0%) cases. Of the 236 patients who underwent preoperative radiotherapy, only 24 (10.2%) received short-course radiotherapy, while 212 (89.8%) received long-course radiotherapy. Of the 339 stage II–III patients, 159 (47%) did not receive any radiotherapy. Radiotherapy was more frequently used in younger patients (P < 0.0001), in patients undergoing abdominoperineal resection (APR) (P < 0.01) and in the north and center of Italy (P < 0.001). Preoperative radiotherapy was more frequently used in younger patients (P < 0.001), in large volume centers (P < 0.05), in patients undergoing APR (P < 0.005) and in the north–center of Italy (P < 0.05).

Conclusion

Our study first identified a treatment disparity among different geographic Italian regions. A more systematic audit is needed to confirm these results and plan adequate interventions.

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Acknowledgments

Prof. Lars Pahlman for critical reading of the manuscript.

Author information

Authors and Affiliations

  1. Coloproctology Unit, Ars Medica Hospital, Rome, Italy

    G. Gagliardi

  2. Department Oncological and Surgical Sciences, 2nd Surgical Clinic, Padua University, Veneto, Italy

    S. Pucciarelli

  3. Department of Surgery and Orthopaedics, Azienda Ospedaliera C. Poma, Mantua, Italy

    C. R. Asteria

  4. Department of Surgery, S. Maria dei Battuti Hospital, S.Vito al Tagliamento (Pn), Italy

    A. Infantino

  5. Department of Colorectal Medical Oncology, National Cancer Institute of Naples, Fondazione G. Pascale, Naples, Italy

    G. Romano

  6. Department of Surgery, AOU S.Orsola-Malpighi, Univeristy of Bologna, Bologna, Italy

    B. Cola

  7. Department of Surgery, San Raffaele Scientific Institute, University of Milan, Milan, Italy

    P. De Nardi

  8. Department of Surgery, Bellaria Hospital, Bologna, Italy

    M. Brulatti

  9. Department of Surgery, San Salvatore Hospital, Pesaro, Italy

    M. Lambertini

  10. Department of Surgery, IRCCS Fondazione Hospital Milan, Milan, Italy

    E. Contessini-Avesani

  11. Department of Surgery, Surgical Clinic, University of Cagliari, Cagliari, Italy

    G. Casula

  12. Department of Surgery, Sacro Cuore Catholic University of Rome, Rome, Italy

    C. Coco

  13. Gastroenterological and Surgical Department, 1st Surgical Clinic, University of Padua, Veneto, Italy

    D. D’Amico

  14. Department of Surgery, Policlinico 2nd University of Naples, Naples, Italy

    F. F. Selvaggi

  15. Department of Surgery, S.Chiara Hospital, Trento, Italy

    C. Eccher

  16. Department of Surgery, Civic Hospital, Lavagna Genova, Italy

    G. D’Ambrosio

  17. Department of Surgery, Civic Hospital, Rovigo, Italy

    F. Galeotti

  18. Department of Surgery, Maggiore Hospital, Bologna, Italy

    E. Jovine

  19. Department of Surgery, IRCCS Fondazione Hospital, Castellana Grotte Bari, Italy

    I. Demma

  20. Department of Surgery, Surgical Clinic, University of Ancona, Ancona, Italy

    A. Fianchini

  21. Department of Surgery, San Bortolo Hospital, Vicenza, Italy

    G. Ambrosino

  22. Department of Surgery, San Filippo Neri Hospital, Rome, Italy

    L. M. Casentino

  23. SICCR Science Center, Italian Society of Colo-Rectal Surgery, Rome, Italy

    M. Fiorino

  24. Department of Surgery, Tulane University School of Medicine, 1430 Tulane Ave., SL-22, New Orleans, LA, 70112-2699, USA

    G. Gagliardi

Authors
  1. G. Gagliardi
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  2. S. Pucciarelli
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  3. C. R. Asteria
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  4. A. Infantino
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  5. G. Romano
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  9. M. Lambertini
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  14. F. F. Selvaggi
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  18. E. Jovine
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Corresponding author

Correspondence to G. Gagliardi.

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Gagliardi, G., Pucciarelli, S., Asteria, C.R. et al. A nationwide audit of the use of radiotherapy for rectal cancer in Italy. Tech Coloproctol 14, 229–235 (2010). https://doi.org/10.1007/s10151-010-0597-9

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  • DOI: https://doi.org/10.1007/s10151-010-0597-9

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