Quality of Life and Functional Outcomes After Watch-and-Wait for Locally Advanced Rectal Cancer: A Meta-analysis

Area of Science:

• Oncology
• Surgical Innovation
• Patient-Reported Outcomes

Background:

• Watch-and-wait (W&W) is an alternative to total mesorectal excision for locally advanced rectal cancer after neoadjuvant therapy.
• This approach aims to preserve bowel function and reduce surgical morbidity.

Purpose of the Study:

• To systematically review and meta-analyze the quality of life (QoL) and bowel function outcomes of W&W versus total mesorectal excision (TME).
• To compare functional outcomes and QoL in rectal cancer patients undergoing different treatment modalities.

Main Methods:

• Systematic review and meta-analysis of randomized trials and observational studies.
• Included 9 studies (923 patients) comparing W&W and TME.
• Primary outcome: QoL; Secondary outcomes: bowel function, fecal incontinence, low anterior resection syndrome.

Main Results:

• No significant difference in overall QoL between W&W and TME groups.
• W&W showed a significant advantage in reducing fecal incontinence.
• Low anterior resection syndrome scores favored the W&W approach.

Conclusions:

• Watch-and-wait provides a functional benefit, particularly in reducing fecal incontinence, without negatively impacting overall QoL.
• Individualized patient assessment is crucial, balancing functional gains against potential oncological risks.