Feasibility study of a Response Surveillance Program in locally advanced mid and low rectal cancer to increase organ preservation

Boubaddi, M.; Fleming, Christina; Vendrely, V.; Frulio, Nora; Salut, Cécile; Denost, Quentin

doi:10.1016/j.ejso.2022.08.031

Cited by 3 publications

(1 citation statement)

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“…Other areas of research are using advanced deep neural networks and radiomics to predict response [58]. Establishing surveillance programmes is key to a successful watch and wait strategy [59]. The goal of research in watch and wait is to enable more accurate risk stratification of surveillance and better patient selection at the earliest stage before treatment is initiated.…”

Section: Introductionmentioning

confidence: 99%

Patient and multidisciplinary team perspectives on watch and wait in rectal cancer

Mohan

Rabie²,

Walsh³

et al. 2023

Colorectal Disease

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Watch and wait as a strategy in rectal cancer management has prompted significant debate [1,2]. Various reports have stated that 8%-30% of patients treated with neoadjuvant therapy will achieve a complete response that allows organ preservation with close surveillance as a potential management option [3,4]. The advantage of avoiding rectal resection, and thereby the morbidity associated with surgery and potential quality of life implications, must be balanced against the oncological safety of such an approach. While mesorectal excision remains the standard of care, watch and wait has been proposed as an option for selected patients.In watch and wait, an enhanced surveillance programme to detect early tumour regrowth and enable successful salvage surgery is critical. Accurate assessment of whether a complete response has occurred is challenging. Currently, multimodal strategies with frequent MRI and endoscopy are used.Communicating to a patient the uncertainties surrounding watch and wait is important for shared decision-making. The possibility of a complete clinical response should be discussed early after diagnosis. International registry data such as from OnCoRe and the International Watch and Wait Database (IWWD) are important in assessing the safety of this approach, while ongoing trials will allow better risk stratification and more informed decision-making [4][5][6][7]. This article will explore the concept of adopting a watch and wait strategy using a case-based multidisciplinary team (MDT) discussion to facilitate debate and the patient perspective. Increasingly watch and wait is being incorporated into cancer guidelines, for example, the latest National Comprehensive Cancer Network guidelines [8]

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Section: Introductionmentioning

confidence: 99%