Author(s):
Temmink, SJ ; Peeters, KC ; Bahadoer, R ; Kranenbarg, MK ; Roodvoets, AG ; Melenhorst, J ; Burger, JW ; Wolthuis, A ; Renehan, AG ; Figueiredo, NL ; Pares, Or ; Martling, A ; Perez, RO ; Beets, GL ; van de Velde, CJ ; Nilsson, PJ ; Aghili, M ; Keshvari, A ; Nouritaromlou, MK ; Ahlberg, M ; Kordnejad, S ; Aleinikov, A ; Dulskas, A ; Asoğlu, O ; Tokmak, H ; Barroca, RG ; Caiado, AF ; Rosa, IA ; Breukink, SO ; Coraglio, MF ; Iseas, S ; Creaven, B ; Winter, DC ; Zaborowski, A ; Cunningham, C ; Gregory, E ; Custers, PA ; Geubels, BM ; DeBrun, L ; D’Hoore, A ; Dimofte, G ; Fechner, K ; Matzel, K ; Fernandez, L ; Herrando, AI ; Vieira, P ; Gaertner, WB ; Madoff, RD ; Gerard, JP ; Jacquinot, F ; Schiappa, R ; Gollins, S ; Gonzalez, M ; Vaccaro, CA ; Habr-Gama, A ; São Julião, G ; Holman, FA ; Hompes, R ; Lameris, W ; Ketelaers, SH ; Rutten, HJ ; Leitner, K ; Mazzarisi, C ; Malcomson, L ; O’Dwyer, ST ; Saunders, M ; Maroli, A ; Mitchell, P ; Murad-Regadas, S ; Pairola, A ; Pedraza, SI ; Sanchez, LF ; Pennings, AJ ; Spinelli, A ; Sun, MA
Date: 2023
Persistent ID: http://hdl.handle.net/10400.26/47631
Origin: Lusíadas Saúde
Subject(s): Neoplasias Colorrectais/tratamento; Terapia Neoadjuvante; Conduta Expectante; Rectal Neoplasms/therapy; Rectal Neoplasms/therapy; Watchful Waiting
Description
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.
