Current status and perspectives on "watch and wait" strategy for rectal cancer patients after clinical complete response following neoadjuvant chemoradiation
10.3760/cma.j.issn.1671-0274.2019.06.004
- VernacularTitle: 直肠癌新辅助治疗后"等待观察"策略实施现状及存在问题
- Author:
Aiwen WU
1
Author Information
1. Ward III of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research, Peking University Cancer Hospital & Institute, Beijing 100142, China
- Publication Type:Journal Article
- Keywords:
Rectal neoplasms;
Neoadjuvant chemoradiation;
"Watch and wait" strategy;
Current status;
Perspectives
- From:
Chinese Journal of Gastrointestinal Surgery
2019;22(6):521-526
- CountryChina
- Language:Chinese
-
Abstract:
Neoadjuvant chemoradiation has been accepted as a standard of care for local advanced middle to low rectal cancer. Patients with clinical complete response (cCR) or near cCR following neoadjuvant chemoradiation may benefit from watch and wait strategy or organ-preserving surgery with good short- and long-term outcome and quality of life (QOL). Yet the criteria of cCR varies and cCR is not consistent with pCR. Therefore, the obstacle to the strategy lies on whether its failure can be salvaged and the complexity of follow-up. Available studies demonstrated that local recurrence or regrowth can be salvaged by surgery without compromising the survival. So, the key is appropriate follow-up schedule and timely salvage. The strategy has not drawn much attention until recently, and relevant studies go slowly because of low data availability, patient awareness, and peer acceptance. We still believe that more and more patients might benefit from this strategy, along with the increasing attention of QOL from the patients. That may be obtained through screening of the right patients and optimizing treatment modality, evaluation methods, and protocol of follow-up.
