The evaluation of follow-up strategies of watch-and-wait patients with a complete response after neoadjuvant therapy in rectal cancer.
chemoradiotherapy
clinical complete response
follow-up
organ preservation
rectal cancer
watch-and-wait
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
revised:
19
01
2021
received:
16
12
2020
accepted:
05
03
2021
pubmed:
17
3
2021
medline:
4
9
2021
entrez:
16
3
2021
Statut:
ppublish
Résumé
Many of the current follow-up schedules in a watch-and-wait approach include very frequent MRI and endoscopy examinations to ensure early detection of local regrowth (LR). The aim of this study was to analyse the occurrence and detection of LR in a watch-and-wait cohort and to suggest a more efficient follow-up schedule. Rectal cancer patients with a clinical complete response after neoadjuvant therapy were prospectively and retrospectively included in a multicentre watch-and-wait registry between 2004 and 2018, with the current follow-up schedule with 3-monthly endoscopy and MRI in the first year and 6 monthly thereafter. A theoretical comparison was constructed for the detection of LR in the current follow-up schedule against four other hypothetical schedules. In all, 50/304 (16%) of patients developed a LR. The majority (98%) were detected at ≤2 years, located in the lumen (94%) and were visible on endoscopy (88%). The theoretical comparison of the different hypothetical schedules suggests that the optimal follow-up schedule should focus on the first 2 years with 3-monthly endoscopy and 3-6 monthly MRI. Longer intervals in the first 2 years will cause delays in diagnosis of LR ranging from 0 to 5 months. After 2 years, increasing the interval from 6 to 12 months did not cause important delays. The optimal follow-up schedule for a watch-and-wait policy in patients with a clinical complete response after chemoradiation for rectal cancer should include frequent endoscopy and to a lesser degree MRI in the first 2 years. Longer intervals, up to 12 months, can be considered after 2 years.
Banques de données
ClinicalTrials.gov
['NCT00939666', 'NCT02278653']
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1785-1792Investigateurs
Stephanie O Breukink
(SO)
Sebastiaan Festen
(S)
Eelco J R de Graaf
(EJR)
Brechtje A Grotenhuis
(BA)
Denise E Hilling
(DE)
Christiaan Hoff
(C)
Martijn P W Intven
(MPW)
Niels Komen
(N)
Koen Cmj Peeters
(KC)
Apollo Pronk
(A)
W H Schreurs
(WH)
Dirk J A Sonneveld
(DJA)
Koen Talsma
(K)
Jurriaan B Tuynman
(JB)
Miranda Kusters
(M)
Henderik L van Westreenen
(HL)
Johannes H W de Wilt
(JHW)
David D E Zimmerman
(DDE)
Informations de copyright
© 2021 The Association of Coloproctology of Great Britain and Ireland.
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