Adoption of Organ Preservation and Surgeon Variability for Patients with Rectal Cancer Does Not Correlate with Worse Survival

Autor: Jin K Kim, Fan Wu, Maria Widmar, Francisco Sanchez-Vega, Julio Garcia-Aguilar, Philip B. Paty, Martin R. Weiser, Jose G. Guillem, Rosa M Jimenez-Rodriguez, Iris H Wei, Hannah Thompson, Emmanouil P. Pappou, J. Joshua Smith, Garrett M. Nash
Rok vydání: 2021
Předmět:
Zdroj: Ann Surg Oncol
ISSN: 1534-4681
1068-9265
DOI: 10.1245/s10434-021-10877-3
Popis: BACKGROUND AND OBJECTIVES: Watch-and-wait is variably adopted by surgeons and the impact of this on outcomes is unknown. We compare the disease-free survival and organ preservation rates of locally advanced rectal cancer patients treated by expert colorectal surgeons at a comprehensive cancer center. METHODS: This study included retrospective data on patients diagnosed with stage II/III rectal adenocarcinoma from January 2013 to June 2017 who initiated neoadjuvant therapy (either with chemoradiation, chemotherapy, or a combination of both) and were treated by an expert colorectal surgeon. RESULTS: 444 locally advanced rectal cancer patients managed by 5 surgeons were included. Tumor distance from the anal verge, type of neoadjuvant therapy, and organ preservation rates varied by treating surgeon. There was no difference in disease-free survival after stratifying by the treating surgeon (p=0.2). On multivariable analysis, neither the type of neoadjuvant therapy nor the treating surgeon was associated with disease-free survival. CONCLUSIONS: While neoadjuvant therapy type and organ preservation rates varied among surgeons, there were no meaningful differences in disease-free survival. These data suggest that amongst expert colorectal surgeons, differing thresholds for selecting patients for watch-and-wait do not affect survival.
Databáze: OpenAIRE
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