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Assessment of a Watch-and-Wait Strategy for Rectal Cancer in Patients With a Complete Response After Neoadjuvant Therapy

Assessment of a Watch-and-Wait Strategy for Rectal Cancer in Patients With a Complete Response... Key PointsQuestionWhat are the rates of local regrowth, pelvic control, and survival when using a watch-and-wait approach for patients with rectal cancer after a clinical complete response to neoadjuvant therapy? FindingsA watchful waiting strategy for 113 patients with rectal cancer achieving a clinical complete response after neoadjuvant therapy resulted in excellent rectal preservation (82%) and pelvic tumor control (91%) in this case series study. However, worse survival was observed compared with 136 patients undergoing total mesorectal excision who had a pathologic complete response; a higher incidence of distant progression was also noted among patients managed by the watch-and-wait strategy who developed local regrowth vs those who did not develop local regrowth. MeaningA watch-and-wait strategy may be safe for most patients, but better risk stratification is needed for more precise patient selection to identify those at high risk of local regrowth who are not optimal candidates. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Oncology American Medical Association

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Publisher
American Medical Association
Copyright
Copyright 2019 American Medical Association. All Rights Reserved.
ISSN
2374-2437
eISSN
2374-2445
DOI
10.1001/jamaoncol.2018.5896
Publisher site
See Article on Publisher Site

Abstract

Key PointsQuestionWhat are the rates of local regrowth, pelvic control, and survival when using a watch-and-wait approach for patients with rectal cancer after a clinical complete response to neoadjuvant therapy? FindingsA watchful waiting strategy for 113 patients with rectal cancer achieving a clinical complete response after neoadjuvant therapy resulted in excellent rectal preservation (82%) and pelvic tumor control (91%) in this case series study. However, worse survival was observed compared with 136 patients undergoing total mesorectal excision who had a pathologic complete response; a higher incidence of distant progression was also noted among patients managed by the watch-and-wait strategy who developed local regrowth vs those who did not develop local regrowth. MeaningA watch-and-wait strategy may be safe for most patients, but better risk stratification is needed for more precise patient selection to identify those at high risk of local regrowth who are not optimal candidates.

Journal

JAMA OncologyAmerican Medical Association

Published: Apr 10, 2019

References