Watch and wait after neoadjuvant treatment in rectal cancer: comparison of outcomes in patients with and without a complete response at first reassessment in the International Watch & Wait Database (IWWD).

Autor:	Temmink SJD; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden., Peeters KCMJ; Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., Bahadoer RR; Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., Kranenbarg EM; Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., Roodvoets AGH; Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., Melenhorst J; Department of Surgery, Maastricht Universitair Medisch Centrum+, Maastricht, the Netherlands., Burger JWA; Department of Surgery, Catharina Ziekenhuis, Eindhoven, the Netherlands., Wolthuis A; Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium., Renehan AG; Manchester Cancer Research Centre, National Institute for Health Research Manchester Biomedical Research Centre, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, UK.; Colorectal and Peritoneal Oncology Centre, Christie National Health Service Foundation Trust, Manchester, UK., Figueiredo NL; Colorectal Surgery, Hospital Lusíadas, Lisbon, Portugal., Pares O; Department of Radiation Oncology, Champalimaud Foundation, Lisbon, Portugal., Martling A; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden., Perez RO; Department of Colorectal Surgery, Angelita and Joaquim Gama Institute, São Paulo, Brazil.; Department of Surgical Oncology, Hospital Beneficencia Portuguesa, São Paulo, Brazil.; Colorectal Surgery Division, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.; Ludwig Institute for Cancer Research, São Paulo Branch, São Paulo, Brazil., Beets GL; Department of Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands.; GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands., van de Velde CJH; Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., Nilsson PJ; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Jazyk:	angličtina
Zdroj:	The British journal of surgery [Br J Surg] 2023 May 16; Vol. 110 (6), pp. 676-684.
DOI:	10.1093/bjs/znad051
Abstrakt:	Background: In rectal cancer, watch and wait for patients with a cCR after neoadjuvant treatment has an established evidence base. However, there is a lack of consensus on the definition and management of a near-cCR. This study aimed to compare outcomes in patients who achieved a cCR at first reassessment versus later reassessment. Methods: This registry study included patients from the International Watch & Wait Database. Patients were categorized as having a cCR at first reassessment or at later reassessment (that is near-cCR at first reassessment) based on MRI and endoscopy. Organ preservation, distant metastasis-free survival, and overall survival rates were calculated. Subgroup analyses were done for near-cCR groups based on the response evaluation according to modality. Results: A total of 1010 patients were identified. At first reassessment, 608 patients had a cCR; 402 had a cCR at later reassessment. Median follow-up was 2.6 years for patients with a cCR at first reassessment and 2.9 years for those with a cCR at later reassessment. The 2-year organ preservation rate was 77.8 (95 per cent c.i. 74.2 to 81.5) and 79.3 (75.1 to 83.7) per cent respectively (P = 0.499). Similarly, no differences were found between groups in distant metastasis-free survival or overall survival rate. Subgroup analyses showed a higher organ preservation rate in the group with a near-cCR categorized exclusively by MRI. Conclusion: Oncological outcomes for patients with a cCR at later reassessment are no worse than those of patients with a cCR at first reassessment. (© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu