학술논문
Watch and wait after neoadjuvant treatment in rectal cancer: comparison of outcomes in patients with and without a complete response at first reassessment in the International Watch & Wait Database (IWWD).
Document Type
Article
Author
Temmink, Sofieke J. D.; Peeters, Koen C. M. J.; Bahadoer, Renu R.; Kranenbarg, Elma Meershoek-Klein; Roodvoets, Annet G. H.; Melenhorst, Jarno; Burger, Jacobus W. A.; Wolthuis, Albert; Renehan, Andrew G.; Figueiredo, Nuno L.; Pares, Oriol; Martling, Anna; Perez, Rodrigo O.; Beets, Geerard L.; de Velde, Cornelis J. H. van; Nilsson, Per J.
Source
Subject
*NEOADJUVANT chemotherapy
*RECTAL cancer
*CANCER prognosis
*DATABASES
*PRESERVATION of organs, tissues, etc.
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Language
ISSN
0007-1323
Abstract
Background: In rectal cancer, watch and wait for patients with a cCR after neoadjuvant treatment has an established evidence base. However, there is a lack of consensus on the definition and management of a near-cCR. This study aimed to compare outcomes in patients who achieved a cCR at first reassessment versus later reassessment. Methods: This registry study included patients from the International Watch & Wait Database. Patients were categorized as having a cCR at first reassessment or at later reassessment (that is near-cCR at first reassessment) based on MRI and endoscopy. Organ preservation, distant metastasis-free survival, and overall survival rates were calculated. Subgroup analyses were done for nearcCR groups based on the response evaluation according to modality. Results: A total of 1010 patients were identified. At first reassessment, 608 patients had a cCR; 402 had a cCR at later reassessment. Median follow-up was 2.6 years for patients with a cCR at first reassessment and 2.9 years for those with a cCR at later reassessment. The 2-year organ preservation rate was 77.8 (95 per cent c.i. 74.2 to 81.5) and 79.3 (75.1 to 83.7) per cent respectively (P = 0.499). Similarly, no differences were found between groups in distant metastasis-free survival or overall survival rate. Subgroup analyses showed a higher organ preservation rate in the group with a near-cCR categorized exclusively by MRI. Conclusion: Oncological outcomes for patients with a cCR at later reassessment are no worse than those of patients with a cCR at first reassessment. [ABSTRACT FROM AUTHOR]