Journal ArticleDOI
Watch and Wait Approach Following Extended Neoadjuvant Chemoradiation for Distal Rectal Cancer: Are We Getting Closer to Anal Cancer Management?
Angelita Habr-Gama,Jorge Sabbaga,Joaquim Gama-Rodrigues,Guilherme Pagin São Julião,Igor Proscurshim,Patricia Bailão Aguilar,Wladimir Nadalin,Rodrigo Oliva Perez +7 more
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TLDR
Extended chemoradiation therapy with additional chemotherapy cycles and 54 Gy of radiation may result in over 50% of sustained (>12 months) complete clinical response rates that may ultimately avoid radical rectal resection.Abstract:
BACKGROUND: no immediate surgery (Watch and Wait) has been considered in select patients with complete clinical response after neoadjuvant chemoradiation to avoid postoperative morbidity and functional disorders after radical surgery. OBJECTIVE: the purpose of this study was to demonstrate the long-term results of patients who had a complete clinical response following an alternative chemoradiation regimen and were managed nonoperatively. DESIGN: this is a prospective study. SETTINGS: this study was conducted at a single center. PATIENTS: seventy consecutive patients with t2-4n0read more
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Watch-and-wait approach versus surgical resection after chemoradiotherapy for patients with rectal cancer (the OnCoRe project): a propensity-score matched cohort analysis
Andrew G Renehan,Lee Malcomson,Richard Emsley,Simon Gollins,Andrew Maw,Arthur Sun Myint,Paul S Rooney,Shabbir Susnerwala,Anthony Blower,Mark P Saunders,Malcolm S Wilson,Nigel Scott,Sarah T O'Dwyer +12 more
TL;DR: Comparing oncological outcomes between patients managed by watch and wait who achieved a clinical complete response and those who had surgical resection to address the shortage of evidence regarding the safety of the watch-and-wait approach is addressed.
Journal ArticleDOI
High-dose chemoradiotherapy and watchful waiting for distal rectal cancer: a prospective observational study
Ane L Appelt,John Pløen,Henrik Harling,Frank Jensen,Lars Henrik Jensen,Jens Christian Riis Jørgensen,Jan Lindebjerg,Søren Rafael Rafaelsen,Anders Jakobsen +8 more
TL;DR: High-dose chemoradiotherapy and watchful waiting might be a safe alternative to abdominoperineal resection for patients with distal rectal cancer.
Journal ArticleDOI
A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis
TL;DR: Most patients treated by watch-and-wait avoid radical surgery and of those who have regrowth almost all have salvage therapy, and more prospective studies are needed to confirm long-term safety.
Journal ArticleDOI
Prospective Validation of a Low Rectal Cancer Magnetic Resonance Imaging Staging System and Development of a Local Recurrence Risk Stratification Model: The MERCURY II Study
Nicholas J. Battersby,Peter How,Brendan Moran,Sigmar Stelzner,Nicholas P. West,Graham Branagan,Joachim Strassburg,Philip Quirke,P. Tekkis,Bodil Ginnerup Pedersen,Mark Gudgeon,Bill Heald,Gina Brown +12 more
TL;DR: The study validated MRI low rectal plane assessment, reducing pCRM involvement and avoiding overtreatment through selective preoperative therapy and rationalized use of permanent colostomy.
Journal ArticleDOI
Chemoradiation therapy for rectal cancer in the distal rectum followed by organ-sparing transanal endoscopic microsurgery (CARTS study).
Maria Verseveld,E. J. R. de Graaf,Cornelis Verhoef,E. van Meerten,Cornelis J. A. Punt,I.H.J.T. de Hingh,Iris D. Nagtegaal,Joost J. Nuyttens,Corrie A.M. Marijnen,J.H.W. de Wilt +9 more
TL;DR: This prospective multicentre study was performed to quantify the number of patients with minimal residual disease after neoadjuvant chemoradiotherapy and transanal endoscopic microsurgery for rectal cancer.
References
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Journal ArticleDOI
Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results.
Angelita Habr-Gama,Rodrigo Oliva Perez,Wladimir Nadalin,Jorge Sabbaga,Ulysses Ribeiro,Afonso Henrique da Silva e Sousa,Fábio Campos,Desidério Roberto Kiss,Joaquim Gama-Rodrigues +8 more
TL;DR: Stage 0 rectal cancer disease is associated with excellent long-term results irrespective of treatment strategy and Surgical resection may not lead to improved outcome in this situation and may be associated with high rates of temporary or definitive stoma construction and unnecessary morbidity and mortality rates.
Journal ArticleDOI
Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data
Monique Maas,Patty J. Nelemans,Vincenzo Valentini,Prajnan Das,Claus Rödel,Li Jen Kuo,Felipe A. Calvo,Julio Garcia-Aguilar,Rob Glynne-Jones,Karin Haustermans,Mohammed Mohiuddin,Salvatore Pucciarelli,William Small,Javier Suárez,George Theodoropoulos,Sebastiano Biondo,Sebastiano Biondo,Regina G. H. Beets-Tan,Geerard L. Beets +18 more
TL;DR: Patients with pCR after chemoradiation have better long-term outcome than do those without pCR, and pCR might be indicative of a prognostically favourable biological tumour profile with less propensity for local or distant recurrence and improved survival.
Journal ArticleDOI
Wait-and-See Policy for Clinical Complete Responders After Chemoradiation for Rectal Cancer
Monique Maas,Regina G. H. Beets-Tan,Doenja M. J. Lambregts,Guido Lammering,Patty J. Nelemans,Sanne M. E. Engelen,Ronald M. van Dam,Rob L. H. Jansen,Meindert N. Sosef,Jeroen W. A. Leijtens,Karel W.E. Hulsewé,Jeroen Buijsen,Geerard L. Beets +12 more
TL;DR: A wait-and-see policy with strict selection criteria, up-to-date imaging techniques, and follow-up is feasible and results in promising outcome at least as good as that of patients with a pCR after surgery.
Journal ArticleDOI
Comparison of Two Neoadjuvant Chemoradiotherapy Regimens for Locally Advanced Rectal Cancer: Results of the Phase III Trial ACCORD 12/0405-Prodige 2
Jean-Pierre Gerard,David Azria,Sophie Gourgou-Bourgade,Isabelle Martel-Laffay,Christophe Hennequin,Pierre-Luc Etienne,Véronique Vendrely,Eric Francois,Olivier Bouché,Xavier Mirabel,Bernard Denis,Laurent Mineur,J. F. Berdah,Marc Mahé,Yves Becouarn,Olivier Dupuis,Gérard Lledo,C. Montoto-Grillot,Thierry Conroy +18 more
TL;DR: The benefit of oxaliplatin was not demonstrated and this drug should not be used with concurrent irradiation, and Cap 50 merits investigation for T3-4 rectal cancers.
Journal ArticleDOI
Complete clinical response after neoadjuvant chemoradiation therapy for distal rectal cancer: characterization of clinical and endoscopic findings for standardization.
Angelita Habr-Gama,Rodrigo Oliva Perez,Gregory Wynn,John H. Marks,Hermann Kessler,Joaquim Gama-Rodrigues +5 more
TL;DR: Strict definition of the clinical and endoscopic findings of patients experiencing complete clinical response after neoadjuvant chemoradiation therapy may provide a useful tool for the understanding of outcomes of patients managed with no immediate surgery allowing standardization of classifications and comparison between the experiences of different institutions.
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Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data
Monique Maas,Patty J. Nelemans,Vincenzo Valentini,Prajnan Das,Claus Rödel,Li Jen Kuo,Felipe A. Calvo,Julio Garcia-Aguilar,Rob Glynne-Jones,Karin Haustermans,Mohammed Mohiuddin,Salvatore Pucciarelli,William Small,Javier Suárez,George Theodoropoulos,Sebastiano Biondo,Sebastiano Biondo,Regina G. H. Beets-Tan,Geerard L. Beets +18 more