Tele-Expert Consultation for Locally Recurrent Rectal Cancer: A Prospective Multicenter Evaluation of the CONNECT-LR...

Our objective was to evaluate the utilization and clinical impact of CONNECT-LR, an asynchronous teleconsultation system for locally recurrent rectal cancer (LRRC), focusing on resectability assessment and clinical trial referral.

In this multicenter, prospective observational study, we included all cases submitted to CONNECT-LR between August 2019 and March 2025, as well as referring physicians and consultants. Referring physicians securely uploaded anonymized clinical and imaging data through a dedicated platform, and consultants responded within 1 week. Data were collected in predefined categories, including consultation purposes and recommendations, physician and institutional characteristics, and user and consultant surveys assessing satisfaction and clinical course. The analysis comprised descriptive statistics.

Overall, 77 consultations were conducted. Most referring physicians were gastrointestinal surgeons (97.4%). The primary purpose of consultation was resectability assessment in 55 cases (71.4%). Of the 34 cases initially judged as unresectable or with uncertain resectability by referring physicians, 24 (70.6%) were reclassified as resectable by consultants, and surgical resection was performed in 15 of these 34 cases (44.1%), predominantly following referral to consultants' institutions. Six patients were enrolled in a randomized controlled trial for resectable LRRC. User satisfaction was high: 93.3% of referring physicians and 76.1% of consultants reported being satisfied or somewhat satisfied.

CONNECT-LR effectively provides expert judgment, often altering resectability assessments and increasing access to curative-intent surgery for patients with LRRC, offering a potential pathway to clinical trial participation. As a feasible, secure, and scalable model, this teleconsultation platform may help reduce regional disparities and expand access to subspecialty care for LRRC.