Watch and wait for Rectal Cancer: A 9 year Experience

Area of Science:

• Oncology
• Gastroenterology
• Surgical Oncology

Background:

• Neoadjuvant long course chemoradiotherapy is standard for locally advanced rectal cancer.
• It aids in tumor reduction, downstaging, and improving resection margins.
• This approach aims to reduce local recurrence rates.

Purpose of the Study:

• To evaluate outcomes of patients with rectal cancer undergoing neoadjuvant chemoradiotherapy.
• To assess the efficacy and safety of a watch and wait program post-neoadjuvant therapy.
• To determine the long-term disease-free survival and need for surgery in this cohort.

Main Methods:

• Analysis of a prospective database from 2011-2019.
• Inclusion of all patients with rectal cancer treated with neoadjuvant chemoradiotherapy.
• Focus on patients who entered a watch and wait program due to complete response.

Main Results:

• 180 of 532 rectal cancer patients received neoadjuvant chemoradiotherapy.
• 61 patients (11%) entered the watch and wait program after complete response.
• 40 patients (65%) remained disease-free, 12 (20%) required surgery, and 9 (15%) had palliative care.

Conclusions:

• Neoadjuvant chemoradiotherapy is a key treatment for locally advanced rectal cancer.
• 34% of treated patients entered a watch and wait program.
• The majority of patients in the watch and wait program successfully avoided major rectal surgery.