Related Experiment Video
Updated: Jun 8, 2025
12:45
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
5.6K
Rectal Cancer Watch-and-Wait Management: Experience of 545 Patients From the US Rectal Cancer Research Group
Samuel H Lai1, Maria Widmar2, John R T Monson3
1Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado.
Diseases of the Colon and Rectum
|November 7, 2024
Summary
The watch-and-wait strategy for rectal cancer is feasible in the US, showing acceptable outcomes. Local regrowth occurred in 23.8% of patients, but salvage surgery was effective, with high survival rates.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Watch-and-wait (WW) management is increasingly used for rectal cancer post-neoadjuvant therapy.
- National data on WW implementation, treatments, and outcomes in the US are limited.
Purpose of the Study:
- To investigate and report on watch-and-wait (WW) management practices and outcomes in the United States.
- To assess the feasibility and effectiveness of WW for locally advanced rectal cancer.
Main Methods:
- Retrospective, multicenter study of 545 patients with stage II or III rectal cancer.
- Intentional watch-and-wait management between January 2015 and August 2022.
- Analysis of patient/tumor characteristics, neoadjuvant therapy, local regrowth, metastasis, salvage surgery, and survival.
Main Results:
- Estimated 3-year local regrowth rate was 23.8%; higher incidence of distant metastases in patients with regrowth (14.2% vs 3.5%).
- Salvage surgery was performed in 88% of patients with regrowth, with 91% achieving margin-negative resections.
- Overall 3-year survival rates were 94.8% (overall) and 96.2% (disease-specific).
Conclusions:
- The watch-and-wait approach is feasible for locally advanced rectal cancer in the US.
- Outcomes are acceptable across diverse practice settings, with effective salvage surgery.
- Local regrowth and metastasis rates align with published data.
Related Concept Videos
01:29Appendicitis-II: Diagnostic Studies and Management
66
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
66
01:21Inflammatory Bowel Disease V: Surgical Management
122
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
122
01:21Cancer Survival Analysis
328
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
328