Watch-and-Wait as a Therapeutic Strategy in Rectal Cancer View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-03-07

AUTHORS

Laurence Bernier, Svetlana Balyasnikova, Diana Tait, Gina Brown

ABSTRACT

Purpose of ReviewPathological complete response is seen in approximately one fifth of rectal cancer patients following neoadjuvant chemoradiation. Since these patients have excellent oncological outcomes, there has been a rapidly growing interest in organ preservation for those who develop a clinical complete response. We review the watch-and-wait strategy and focus on all aspects of this hot topic, including who should be considered for this approach, how should we identify treatment response and what are the expected outcomes.Recent FindingsThe major challenges in interpreting the data on watch-and-wait are the significant heterogeneity of patients selected for this approach and of methods employed to identify them. The evidence available comes mostly from retrospective cohort studies, but has shown good oncological outcomes, including the rate of successful salvage surgery, locoregional control and overall survival.SummaryThere is currently not enough and not robust enough evidence to support watch-and-wait as a standard approach, outside a clinical trial, for patients achieving clinical complete response following neoadjuvant chemoradiation. Furthermore, there is a lack of data on long-term outcomes. However, the results we have so far are promising, and there is therefore an urgent need for randomised control studies such as the TRIGGER trial to confirm the safety of this strategy. More... »

PAGES

37-55

References to SciGraph publications

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  • 2015-12-14. Predictors of Pathologic Complete Response Following Neoadjuvant Chemoradiotherapy for Rectal Cancer in ANNALS OF SURGICAL ONCOLOGY
  • 2014-12-18. Baseline neutrophil-lymphocyte ratio (≥2.8) as a prognostic factor for patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiation in RADIATION ONCOLOGY
  • 2008-04-04. An Interval >7 Weeks between Neoadjuvant Therapy and Surgery Improves Pathologic Complete Response and Disease–Free Survival in Patients with Locally Advanced Rectal Cancer in ANNALS OF SURGICAL ONCOLOGY
  • 2016-12-20. Organ preservation with local excision or active surveillance following chemoradiotherapy for rectal cancer in BRITISH JOURNAL OF CANCER
  • 2017-08-29. A rectal cancer feasibility study with an embedded phase III trial design assessing magnetic resonance tumour regression grade (mrTRG) as a novel biomarker to stratify management by good and poor response to chemoradiotherapy (TRIGGER): study protocol for a randomised controlled trial in TRIALS
  • 2015-10-23. Organ Preservation in Rectal Adenocarcinoma: a phase II randomized controlled trial evaluating 3-year disease-free survival in patients with locally advanced rectal cancer treated with chemoradiation plus induction or consolidation chemotherapy, and total mesorectal excision or nonoperative management in BMC CANCER
  • 2015-07-22. Assessment of Clinical Complete Response After Chemoradiation for Rectal Cancer with Digital Rectal Examination, Endoscopy, and MRI: Selection for Organ-Saving Treatment in ANNALS OF SURGICAL ONCOLOGY
  • 2012-03-27. Impact of Interval between Neoadjuvant Chemoradiotherapy and TME for Locally Advanced Rectal Cancer on Pathologic Response and Oncologic Outcome in ANNALS OF SURGICAL ONCOLOGY
  • 2015-11-25. Rectal cancer with complete clinical response after neoadjuvant chemoradiotherapy, surgery, or “watch and wait” in INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
  • 2007-07-20. Outcomes of Salvage Surgery for Squamous Cell Carcinoma of the Anal Canal in ANNALS OF SURGICAL ONCOLOGY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11888-018-0398-5

    DOI

    http://dx.doi.org/10.1007/s11888-018-0398-5

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1101368618

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29576755


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