Defining Standard Data Reporting in Pelvic Exenteration Surgery for Rectal Cancer: A PelvEx Collaborative Review of Current Data Reporting

Simple Summary: Pelvic exenteration is a radical surgery for locally advanced and recurrent rectal tumors. Advances in perioperative care have renewed interest in this once palliative procedure, offering a potential cure for select patients. However, this renewed interest has corresponded with an influx in the volume of literature reporting on this procedure, which has led to an increase in outcomes reported by various authors. We aim to systematically review and document all outcomes currently reported in the field of pelvic exenteration for rectal cancer. This study is the initial step in a multi-step project aimed at creating a comprehensive core data set that includes core outcomes, measurements, and descriptors through a Delphi process involving all key stakeholders. The final core data set will help guide future data collection, analysis, and treatment strategies for this rare procedure. Additionally, this core data set will serve as the foundation for future PelvEx multi-center collaboration and will inform guideline development across our network. INTRODUCTION: Pelvic exenteration (PEx) is a radical procedure used in the treatment of locally advanced (LARC) and locally recurrent rectal cancer (LRRC). With recent advancements in perioperative treatment regimens, there has been renewed interest in this procedure as it offers the opportunity for complete tumour resection in a select cohort. This has resulted in large heterogeneity in outcome reporting, making comparing and conducting a meta-analysis of published results challenging. Standardising outcome reporting will ensure meaningful data reporting and allow the cross-centre comparison of data. AIMS: To conduct a systematic review of the current literature, to identify the various outcomes reported for PEx in rectal cancer, and to develop a standard outcome reporting set. METHODS: A systematic review was carried out following the PRISMA guidelines. Relevant domains were identified first. Data elements (DEs) were extracted verbatim prior to standardisation and mapping to relevant domains. RESULTS: There has been a noticeable trend of increased literature on PEx in the last decade. Forty-nine papers were identified. A total of 1549 DEs were extracted verbatim. These were standardised to 119 unique DEs mapped to ten distinct domains capturing the patient care journey. There was large variation in the frequency of reporting, with some key outcomes reported in a limited number of studies. CONCLUSIONS: There is considerable heterogeneity at present in data reporting for PEx in LARC and LRRC. Standardisation of outcomes is the first step in guiding the development of a core information set to overcome heterogeneity and guide future research development.