Related Experiment Video
Updated: Jun 24, 2025
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
"WATCH AND WAIT" STRATEGY IN RECTAL CANCER PATIENTS WITH A COMPLETE CLINICAL RESPONSE AFTER NEOADJUVANT
L Kokaine1,2, M Radzina2, M Liepa2
1Pauls Stradiņš Clinical University Hospital, Department of Surgery, Riga, Latvia
Background:
The non-operative management of rectal adenocarcinoma (RA) after neoadjuvant chemoradiation therapy (nCRT) has gained increasing attention. The "Watch and Wait" ("W&W") strategy allows one to avoid surgery-related reduction in the quality of life due to permanent pelvic organ dysfunction or irreversible stoma. Still, the oncological safety of this strategy is under evaluation.
Aim:
To share a single-center experience of the "W&W" strategy.
Materials And Methods:
The retrospective analysis of 125 patients who received nCRT in 2016-2021 was performed. Patients who met the European Society for Medical Oncology (ESMO, 2017) criteria of clinical complete response (cCR) and received non-operative management were analyzed.
Results:
Ten patients (8%) were re-staged after nCRT as cCR and followed the "W&W" strategy. Patients' characteristics: 7 female, 3 male; mean age 67.3 years. Tumor characteristics: pre-treatment N+ was present in 7 cases; G1 adenocarcinoma in a majority of cases; mean tumor distance from the anal verge - 5.85 cm; mean tumor circumference - 71%; mean tumor length - 3.87 cm. The mean follow-up time was 30 months. Local regrowth or/and distant metastases developed in 3 cases. The 2-year disease-free survival was 70%.
Conclusions:
Most of the patients following the "W&W" strategy have benefited. However, to reduce the number of relapses, it is necessary to perform a more careful selection of patients.
More Related Videos
09:11Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
Published on: May 24, 2024
04:04Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017