"Watch and Wait" for complete clinical response after neoadjuvant chemoradiotherapy for rectal cancer.

"Watch and Wait" for complete clinical response after neoadjuvant chemoradiotherapy for rectal cancer. Minerva Chir. 2019 Sep 30;: Authors: Peacock O, Chang GJ Abstract The management of rectal cancer has evolved substantially over recent decades, becoming increasingly complex. This was once a disease associated with high mortality and limited treatment options that typically necessitated a permanent colostomy, has now become a model for multidisciplinary evaluation, treatment and surgical advancement. Despite advances in the rates of total mesorectal excision, decreased local recurrence and increased 5-year survival rates, the multimodal treatment of rectal cancer is associated with a significant impact on long- term functional and quality of life outcomes including risks of bowel, bladder and sexual dysfunction, and potential need for a permanent stoma. There is great interest in strategies to decrease the toxicity of treatment, including selective use of radiation, chemotherapy or even surgery. The modern concept of selective use of surgery for patients with rectal cancer are based on the observed pathological complete response in approximately 10-20% of patients following long-course chemoradiation therapy. While definitive surgical resection remains the standard of care for all patients with non-metastatic rectal cancer, a growing number of studies are providing supportive evidence for a watch-and-wait, organ preserving approach...
Source: Minerva Chirurgica - Category: Surgery Tags: Minerva Chir Source Type: research