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Outcomes of Locally Advanced Rectal Cancer Patients Following Complete Clinical Response After Neoadjuvant Treatment
May Ashour1, Sylvia Armanious1, Heba Rashad1
1Radiation Oncology, National Cancer Institute, Cairo, EGY.
Cureus
|October 30, 2024
Summary
Watchful waiting is a viable option for locally advanced rectal cancer patients achieving complete response after neoadjuvant treatment. This approach shows comparable survival outcomes to surgery, particularly for those avoiding permanent stomas.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Watchful waiting and non-operative management are emerging for rectal cancer patients with complete clinical response post-neoadjuvant therapy.
- This strategy is particularly relevant for patients facing permanent stoma surgery.
Purpose of the Study:
- To compare outcomes of watchful waiting versus surgical management in locally advanced rectal cancer patients with complete clinical response.
- To evaluate overall survival (OS), disease-free survival (DFS), metastasis-free survival (MFS), and local recurrence-free survival (LRFS).
Main Methods:
- Retrospective study of 51 patients with locally advanced rectal cancer.
- Patients achieved complete clinical response after neoadjuvant treatment.
- Comparison between surgical group (31 patients) and watchful waiting group (20 patients).
Main Results:
- No significant difference in five-year overall survival between groups (65% for both).
- Five-year disease-free survival was 68% for watchful waiting vs. 62% for surgery (p=0.75).
- Five-year local recurrence-free survival was 100% for watchful waiting vs. 83% for surgery (p=0.15).
Conclusions:
- Watchful waiting is feasible for locally advanced rectal cancer patients with complete clinical response.
- This approach does not compromise disease-related outcomes, especially for distal rectal cancers requiring stoma.
- Further prospective studies are recommended for validation.
