Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Despite absence of level 1 evidence on the long-term oncological safety of non-operative management for rectal cancer (watch and wait), increased implementation has occurred globally over the past decades. In Sweden, a pan-national prospective non-randomized study was initiated in 2017 to assess its implementation. METHOD: Patients with biopsy-proven rectal cancer receiving neoadjuvant therapy according to national guidelines in whom a clinical complete response was detected at reassessment were eligible for inclusion following informed consent. Only patients with an opportunistic watch-and-wait approach were included. Inclusion and follow-up, according to the study protocol, was managed at the participating study centres. The primary outcome measure of the study is 3-year disease-free survival. Here, the secondary short-term outcomes local regrowth rate, distant metastasis rate and outcomes after surgery for regrowth, at 6 months follow-up, are reported. RESULTS: Between January 2017 and February 2023, 211 patients with a clinical complete response were included in the study. Thirty-three (16%) patients developed suspicious regrowth within 6 months of inclusion. Thirty-two of 33 patients had abdominal resectional surgery for regrowth. The curative intention rate was 94% for patients with regrowth. Three patients (1.4%) developed distant metastases within 6 months of inclusion. CONCLUSION: This Swedish national study on watch and wait reports regrowth rates after 6 months are in line with previous reports in the literature. Nearly all patients with early regrowth could be treated with salvage surgery and curative intent.
Source: BJS Open
Institutions: Sahlgrenska University Hospital, Region Västra Götaland, University of Gothenburg, Lund University, Skåne University Hospital, Karolinska University Hospital, Karolinska Institutet, Uppsala University, Västmanlands sjukhus Västerås, Region Västmanland, Uppsala University Hospital, University Hospital of Umeå, Umeå University, Linköping University, Linköping University Hospital, Örebro University, Örebro University Hospital
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,933
Awards: G106503791, G1067834687, G1577042672, Improving the treatment for colorectal and anal cancer - studies evaluating treatment and surgical techniques with an emphasis on Quality of Life (QoL), G2149455459, Tailored treatment to improve outcome and long-term Quality of Life in patients with colorectal and anal cancer
OpenAlex ID: W4406794125