Assessment of Quality of Life in Rectal Cancer with Organ-Preservation Treatment: Are We There yet?

Baird, P.; Steinke, Jacqueline; Minnaar, Helen; Stewart, Alexandra J.

doi:10.1016/j.clon.2022.11.002

Cited by 2 publications

(3 citation statements)

References 65 publications

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“…Specific parameters should be followed to achieve optimal high-resolution sequences, including a small FOV, a small slice thickness (no more than 3 mm), and the correct scan plane alignment (perpendicular to the rectal wall at the level of the tumor). On T2-W sequences, the recurrence showed the same findings as pre-treated lesions: a solid hyperintense lesion, with or without a more intense area if it is a mucinous lesion, and a restricted signal on DWI sequences [ 40 , 198 , 199 ].…”

Section: Discussionmentioning

confidence: 93%

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Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications

Muzio

Fusco

Cutolo

et al. 2023

JCM

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Rectal cancer (RC) is one of the deadliest malignancies worldwide. Surgery is the most common treatment for RC, performed in 63.2% of patients. The type of surgical approach chosen aims to achieve maximum residual function with the lowest risk of recurrence. The selection is made by a multidisciplinary team that assesses the characteristics of the patient and the tumor. Total mesorectal excision (TME), including both low anterior resection (LAR) and abdominoperineal resection (APR), is still the standard of care for RC. Radical surgery is burdened by a 31% rate of major complications (Clavien–Dindo grade 3–4), such as anastomotic leaks and a risk of a permanent stoma. In recent years, less-invasive techniques, such as local excision, have been tested. These additional procedures could mitigate the morbidity of rectal resection, while providing acceptable oncologic results. The “watch and wait” approach is not a globally accepted model of care but encouraging results on selected groups of patients make it a promising strategy. In this plethora of treatments, the radiologist is called upon to distinguish a physiological from a pathological postoperative finding. The aim of this narrative review is to identify the main post-surgical complications and the most effective imaging techniques.

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Section: Discussionmentioning

confidence: 93%

“…Therefore, the radiologist’s role in using MRI is critical since it is necessary to assess the rectal wall status (edema due to radiotherapy treatment and vascularization status). Consequently, contrast medium should be employed [ 198 , 199 ].…”

Section: Discussionmentioning

confidence: 99%

Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications

Muzio

Fusco

Cutolo

et al. 2023

JCM

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“…The long-term local recurrence rate is approximately 25% for patients obtaining CR [3]. Organ preservation approaches are thus likely to offer a benefit regarding quality of life (QoL) to a remarkable number of patients, especially if sphincter-sparing surgery is impossible due to distal tumor location (<4-6 cm from anal verge) [4][5][6]. Patients thus tended to prefer non-operative management (NOM) when asked to decide between CRT + resection and NOM [7].…”

Section: Introductionmentioning

confidence: 99%

Patient-Relevant Costs for Organ Preservation versus Radical Resection in Locally Advanced Rectal Cancer

Wurschi,

Rühle,

Domschikowski

et al. 2024

Cancers

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Total neoadjuvant therapy (TNT) is an evolving treatment schedule for locally advanced rectal cancer (LARC), allowing for organ preservation in a relevant number of patients in the case of complete response. Patients who undergo this so-called “watch and wait” approach are likely to benefit regarding their quality of life (QoL), especially if definitive ostomy could be avoided. In this work, we performed the first cost-effectiveness analysis from the patient perspective to compare costs for TNT with radical resection after neoadjuvant chemoradiation (CRT) in the German health care system. Individual costs for patients insured with a statutory health insurance were calculated with a Markov microsimulation. A subgroup analysis from the prospective “FinTox” trial was used to calibrate the model’s parameters. We found that TNT was less expensive (−1540 EUR) and simultaneously resulted in a better QoL (+0.64 QALYs) during treatment and 5-year follow-up. The average cost for patients under TNT was 4711 EUR per year, which was equivalent to 3.2% of the net household income. CRT followed by resection resulted in higher overall costs for ostomy care, medication and greater loss of earnings. Overall, TNT appeared to be more efficacious and cost-effective from a patient’s point of view in the German health care system.

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Assessment of Quality of Life in Rectal Cancer with Organ-Preservation Treatment: Are We There yet?

Cited by 2 publications

References 65 publications

Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications

Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications

Patient-Relevant Costs for Organ Preservation versus Radical Resection in Locally Advanced Rectal Cancer

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