Non-surgical “Watch and Wait” Approach to Rectal Cancer

AbstractPurpose of ReviewThe standard of care for locally advanced rectal cancer is preoperative chemoradiation (CRT) followed by total mesorectal excision (TME). Patients who achieve a pathologic complete response (pCR) to CRT have favorable oncologic outcomes. Given the significant morbidity and long-term effects on quality of life associated with radical resection, the role of surgery in the subgroup of patients with a clinical complete response (cCR), of whom a significant proportion may have a pCR, is under debate.Recent FindingsAn emerging tailored approach to treatment is a “watch and wait” strategy in patients who have a cCR after CRT with the goal of organ preservation. However, concordance between a cCR and pCR is not highly reliable, and improved multimodality prediction algorithms are needed to better predict which patients have achieved a pCR and can therefor e safely undergo a “watch and wait” approach.SummaryWe review the current data on non-operative management of rectal cancer and ongoing controversies associated with this approach.
Source: Current Colorectal Cancer Reports - Category: Cancer & Oncology Source Type: research