Artigo Acesso aberto Produção Nacional Revisado por pares

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)

2023; Oxford University Press; Volume: 110; Issue: 6 Linguagem: Inglês

10.1093/bjs/znad051

ISSN

1365-2168

Autores

Sofieke Temmink, Koen Peeters, Renu R. Bahadoer, Elma Meershoek‐Klein Kranenbarg, Annet G.H. Roodvoets, Jarno Melenhorst, Jacobus W. A. Burger, Albert Wolthuis, Andrew G. Renehan, Nuno Figueiredo, Oriol Parés, Anna Martling, Rodrigo Oliva Perez, Geerard L. Beets, Cornelis J.�H. van de Velde, Per J. Nilsson, Mahdi Aghili, Amir Keshvari, M K Nouritaromlou, Madeleine Ahlberg, Shahrzad Kordnejad, A Aleinikov, Audrius Dulskas, Oktar Asoğlu, Handan Tokmak, Rita Barroca, A Caiado, I A L Rosa, Stéphanie O. Breukink, Mariana Coraglio, Soledad Iseas, Bernadette S. Creaven, D. C. Winter, Alexandra Zaborowski, Chris Cunningham, E Gregory, Petra A. Custers, Barbara M. Geubels, Lynn Debrun, André D’Hoore, G Dimofte, Katja Fechner, Klaus E. Matzel, Laura M. Fernández, Alberto Ignacio Herrando, Pedro Vieira, Wolfgang B. Gaertner, Robert D. Madoff, Jean‐Pierre Gérard, F Jacquinot, Renaud Schiappa, Simon Gollins, Maynor G. González, Carlos Vaccaro, Angelita Habr‐Gama, Julião G P São, Fabian A. Holman, Roel Hompes, Wytze Laméris, Stijn H. J. Ketelaers, H.J.T. Rutten, Katharina Leitner, Claudia Mazzarisi, Lee Malcomson, Sarah O’Dwyer, Mark Saunders, Annalisa Maroli, Paul Mitchell, Sthela Maria Murad‐Regadas, Alejandro Pairola, Salazar I Pedraza, Loria F Sanchez, Alexander Pennings, Antonino Spinelli, Myint A Sun,

Tópico(s)

Colorectal Cancer Screening and Detection

Resumo

Abstract 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.

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