Academic Journal
The watch-and-wait strategy versus surgical resection for rectal cancer patients with a clinical complete response after neoadjuvant chemoradiotherapy
| Title: | The watch-and-wait strategy versus surgical resection for rectal cancer patients with a clinical complete response after neoadjuvant chemoradiotherapy |
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| Authors: | Qiao-xuan Wang, Rong Zhang, Wei-wei Xiao, Shu Zhang, Ming-biao Wei, Yong-heng Li, Hui Chang, Wei-hao Xie, Li-ren Li, Pei-rong Ding, Gong Chen, Zhi-fan Zeng, Wei-hu Wang, Xiang-bo Wan, Yuan-hong Gao |
| Source: | Radiation Oncology, Vol 16, Iss 1, Pp 1-8 (2021) |
| Publisher Information: | BMC, 2021. |
| Publication Year: | 2021 |
| Collection: | LCC:Medical physics. Medical radiology. Nuclear medicine LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| Subject Terms: | Medical physics. Medical radiology. Nuclear medicine, R895-920, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| More Details: | Abstract Background The watch-and-wait strategy offers a non-invasive therapeutic alternative for rectal cancer patients who have achieved a clinical complete response (cCR) after chemoradiotherapy. This study aimed to investigate the long-term clinical outcomes of this strategy in comparation to surgical resection. Methods Stage II/III rectal adenocarcinoma patients who received neoadjuvant chemoradiotherapy and achieved a cCR were selected from the databases of three centers. cCR was evaluated by findings from digital rectal examination, colonoscopy, and radiographic images. Patients in whom the watch-and-wait strategy was adopted were matched with patients who underwent radical resection through 1:1 propensity score matching analyses. Survival was calculated and compared in the two groups using the Kaplan–Meier method with the log rank test. Results A total of 117 patients in whom the watch-and-wait strategy was adopted were matched with 354 patients who underwent radical resection. After matching, there were 94 patients in each group, and no significant differences in term of age, sex, T stage, N stage or tumor location were observed between the two groups. The median follow-up time was 38.2 months. Patients in whom the watch-and-wait strategy was adopted exhibited a higher rate of local recurrences (14.9% vs. 1.1%), but most (85.7%) were salvageable. Three-year non-regrowth local recurrence-free survival was comparable between the two groups (98% vs. 98%, P = 0.506), but the watch-and-wait group presented an obvious advantage in terms of sphincter preservation, especially in patients with a tumor located within 3 cm of the anal verge (89.7% vs. 41.2%, P |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 1748-717X |
| Relation: | https://doaj.org/toc/1748-717X |
| DOI: | 10.1186/s13014-021-01746-0 |
| Access URL: | https://doaj.org/article/babda910c4bb48308aaf8a3cb193ba1f |
| Accession Number: | edsdoj.babda910c4bb48308aaf8a3cb193ba1f |
| Database: | Directory of Open Access Journals |
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| ISSN: | 1748717X |
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| DOI: | 10.1186/s13014-021-01746-0 |
| Published in: | Radiation Oncology |
| Language: | English |