Salvage Surgery With Organ Preservation for Patients With Local Regrowth After Watch and Wait: Is It Still Possible?

Diseases of the Colon and Rectum
Laura M FernandezRodrigo O Perez

Abstract

Patients with rectal cancer who achieve complete clinical response after neoadjuvant chemoradiation have been managed nonoperatively. Thirty percent of these patients may develop a local regrowth, and salvage resection with radical surgery is usually recommended. However, selected patients could be offered additional organ preservation by local excision. We hypothesized that patients with baseline T2 who underwent neoadjuvant therapy (for the specific purpose of achieving a complete clinical response) were more likely to harbor recurrent disease at an earlier stage and amenable to organ preservation strategies (local excision) when compared with T3/T4 (undergoing neoadjuvant chemoradiation for oncologic reasons). The purpose of this study was to compare patients with local regrowth requiring salvage resection according to their baseline stage. This was a retrospective review of consecutive patients with nonmetastatic distal rectal cancer undergoing neoadjuvant chemoradiation. The study included 2 independent tertiary centers with institutional watch-and-wait organ preservation programs. Consecutive patients with distal rectal cancer (cT2-4N1-2M0) managed by watch and wait and local regrowth from 2 institutions were included. Fi...Continue Reading

References

Feb 1, 2008·International Journal of Radiation Oncology, Biology, Physics·Angelita Habr-GamaIvan Cecconello
Jul 19, 2015·The Lancet Oncology·Julio Garcia-AguilarUNKNOWN Timing of Rectal Cancer Response to Chemoradiation Consortium
Jun 27, 2018·Diseases of the Colon and Rectum·Sean M WrennPeter A Cataldo
Mar 15, 2019·Diseases of the Colon and Rectum·Angelita Habr-GamaRodrigo Oliva Perez
Apr 23, 2019·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Irfan NasirNuno Figueiredo

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