EP270 - 10 Years Retrospective Analysis of Patients with Rectal Adenocarcinoma Operated at a Public Hospital in Rio de Janeiro Brazil

Purpose/Background: To evaluate the epidemiological profile of patients operated for rectal adenocarcinoma in a public tertiary hospital over the last ten years, and to analyze trends in staging, treatment, and outcomes. An additional analysis of the interval between diagnosis and surgery is currently being incorporated.

Methods/Interventions: A retrospective review was performed including all patients undergoing curative surgery for histologically confirmed middle or lower rectal adenocarcinoma between 2015 and 2024 at a public colorectal unit in Rio de Janeiro, Brazil. Data collected included demographic characteristics, tumor location, pathological stage, use of neoadjuvant therapy, and postoperative mortality. Statistical analysis was descriptive, comparing two diagnostic periods (2015–2019 vs 2020–2024). The time from diagnosis to surgery will be analyzed and presented as a separate variable in the final dataset.

Results/Outcomes: A total of 187 patients were included. Most patients were older than 50 years (81.8%), and 55.1% were female. Tumor location was evenly distributed between the lower (50.3%) and middle rectum (49.7%). The stage distribution was: 0 (10.7%), I (21.9%), II (24.1%), III (34.2%), and IV (9.1%). Neoadjuvant therapy was administered to 81.3% of patients, predominantly among those with lower rectal tumors (92.6% vs 69.9% for middle rectum). Surgical mortality occurred in 1.6% (3 patients). Comparing the two time periods, there was a mild reduction in stage IV cases (12.0% to 5.1%) and an overall stable distribution of earlier stages. *The mean interval between diagnosis and surgery is currently under evaluation and will be incorporated into the final analysis.

Conclusion/Discussion: This ten-year review highlights a predominance of locally advanced rectal cancer (stages II–III) in patients treated at a public hospital in Rio de Janeiro. Despite high adherence to neoadjuvant protocols and acceptable surgical mortality, the persistence of advanced disease at presentation underscores the need for improved early diagnosis and optimized referral pathways in the public health system. The forthcoming analysis of the diagnosis-to-surgery interval is expected to further elucidate system-level delays impacting oncologic outcomes.