Patient and multidisciplinary team perspectives on watch and wait in rectal cancer.
complete response
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 2023
07 2023
Historique:
revised:
21
03
2023
received:
12
02
2023
accepted:
25
03
2023
medline:
24
7
2023
pubmed:
21
7
2023
entrez:
21
7
2023
Statut:
ppublish
Résumé
This article adopts a multidisciplinary approach, including surgery, oncology, radiology and patient perspectives, to discuss the key points of debate surrounding a watch and wait approach. In an era of shared decision-making, discussion of watch and wait as an option in the context of complete clinical response is appropriate, although it is not the gold standard treatment. Key challenges are the difficulty in assessing for a complete clinical response, prediction of recurrence and access to timely diagnostics for surveillance. Salvage surgery has good results if regrowth is detected early but does have imperfect outcomes, with only a 90% salvage rate. Good communication with patients about the risks and alternatives is essential. Patients undergoing watch and wait should ideally be enrolled in prospective registries or clinical trials.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1489-1497Informations de copyright
© 2023 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.
Références
Dossa F, Chesney TR, Acuna SA, Baxter NN. A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2017;2(7):501-13.
Beard BW, Rettig RL, Ryoo JJ, Parker RA, McLemore EC, Attaluri V. Watch-and-wait compared to operation for patients with complete response to neoadjuvant therapy for rectal cancer. J Am Coll Surg. 2020;231(6):681-92.
Gerard JP, Barbet N, Schiappa R, Magne N, Martel I, Mineur L, et al. Neoadjuvant chemoradiotherapy with radiation dose escalation with contact x-ray brachytherapy boost or external beam radiotherapy boost for organ preservation in early cT2-cT3 rectal adenocarcinoma (OPERA): a phase 3, randomised controlled trial. Lancet Gastroenterol Hepatol. 2023;8(4):356-67.
van der Valk MJM, Hilling DE, Bastiaannet E, Meershoek-Klein Kranenbarg E, Beets GL, Figueiredo NL, et al. Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study. Lancet. 2018;391(10139):2537-45.
Fernandez LM, Sao Juliao GP, Figueiredo NL, Beets GL, van der Valk MJM, Bahadoer RR, et al. Conditional recurrence-free survival of clinical complete responders managed by watch and wait after neoadjuvant chemoradiotherapy for rectal cancer in the International Watch & Wait Database: a retrospective, international, multicentre registry study. Lancet Oncol. 2021;22(1):43-50.
Renehan AG, Malcomson L, Emsley R, Scott N, O'Dwyer ST, OnCoRe project investigators. Watch-and-wait versus surgical resection for patients with rectal cancer - authors' reply. Lancet Oncol. 2016;17(4):e134-e5.
Renehan AG, Malcomson L, Emsley R. Watch-and-wait approach for rectal cancer: concepts of a subject-specific method. Lancet Gastroenterol Hepatol. 2017;2(9):627.
Benson AB, Venook AP, Al-Hawary MM, Azad N, Chen YJ, Ciombor KK, et al. Rectal cancer, version 2.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2022;20(10):1139-67.
NICE. NICE Guideline Colorectal Cancer NICE Guidelines [Internet]. 1.3.5.
Bahadoer RR, Peeters K, Beets GL, Figueiredo NL, Bastiaannet E, Vahrmeijer A, et al. Watch and wait after a clinical complete response in rectal cancer patients younger than 50 years. Br J Surg. 2021;109(1):114-20.
Rombouts AJM, Al-Najami I, Abbott NL, Appelt A, Baatrup G, Bach S, et al. Can we Save the rectum by watchful waiting or transanal microsurgery following (chemo)radiotherapy versus total mesorectal excision for early rectal cancer (STAR-TREC study)?: protocol for a multicentre, randomised feasibility study. BMJ Open. 2017;7(12):e019474.
Bahadoer RR, Dijkstra EA, van Etten B, Marijnen CAM, Putter H, Kranenbarg EM, et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22(1):29-42.
Dijkstra EA, Nilsson PJ, Hospers GAP, Bahadoer RR, Meershoek-Klein Kranenbarg E, Roodvoets AGH, et al. Locoregional failure during and after short-course radiotherapy followed by chemotherapy and surgery compared to long-course chemoradiotherapy and surgery - a five-year follow-up of the RAPIDO trial. Ann Surg. 2023. [Online ahead of print]. https://doi.org/10.1097/SLA.0000000000005799 online ahead of print
Conroy T, Bosset JF, Etienne PL, Rio E, Francois E, Mesgouez-Nebout N, et al. Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22(5):702-15.
Cisel B, Pietrzak L, Michalski W, Wyrwicz L, Rutkowski A, Kosakowska E, et al. Long-course preoperative chemoradiation versus 5 × 5 Gy and consolidation chemotherapy for clinical T4 and fixed clinical T3 rectal cancer: long-term results of the randomized Polish II study. Ann Oncol. 2019;30(8):1298-303.
Garcia-Aguilar J, Patil S, Gollub MJ, Kim JK, Yuval JB, Thompson HM, et al. Organ preservation in patients with rectal adenocarcinoma treated with total neoadjuvant therapy. J Clin Oncol. 2022;40(23):2546-56.
Habr-Gama A, Sao Juliao GP, Fernandez LM, Vailati BB, Andrade A, Araujo SEA, et al. Achieving a complete clinical response after neoadjuvant chemoradiation that does not require surgical resection: it may take longer than you think! Dis Colon Rectum. 2019;62(7):802-8.
Lefevre JH, Mineur L, Kotti S, Rullier E, Rouanet P, de Chaisemartin C, et al. Effect of interval (7 or 11 weeks) between neoadjuvant radiochemotherapy and surgery on complete pathologic response in rectal cancer: a multicenter, randomized, controlled trial (GRECCAR-6). J Clin Oncol. 2016;34(31):3773-80.
Garcia-Aguilar J, Smith DD, Avila K, Bergsland EK, Chu P, Krieg RM, et al. Optimal timing of surgery after chemoradiation for advanced rectal cancer: preliminary results of a multicenter, nonrandomized phase II prospective trial. Ann Surg. 2011;254(1):97-102.
Rullier E, Vendrely V, Asselineau J, Rouanet P, Tuech JJ, Valverde A, et al. Organ preservation with chemoradiotherapy plus local excision for rectal cancer: 5-year results of the GRECCAR 2 randomised trial. Lancet Gastroenterol Hepatol. 2020;5(5):465-74.
Bushati M, Pucciarelli S, Gennaro N, Maretto I, Toppan P, Perin A, et al. Local excision in rectal cancer patients with major or complete clinical response after neoadjuvant therapy: a case-matched study. Int J Colorectal Dis. 2019;34(12):2129-36.
Habr-Gama A, Perez RO, Nadalin W, Sabbaga J, Ribeiro U Jr, Silva e Sousa AH Jr, et al. Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results. Ann Surg. 2004;240(4):711-7; discussion 7-8.
Jones HJS, Al-Najami I, Baatrup G, Cunningham C. Local excision after (near) complete response of rectal cancer to neoadjuvant radiation: does it add value? Int J Colorectal Dis. 2021;36(5):1017-22.
Frin AC, Evesque L, Gal J, Benezery K, Francois E, Gugenheim J, et al. Organ or sphincter preservation for rectal cancer. The role of contact X-ray brachytherapy in a monocentric series of 112 patients. Eur J Cancer. 2017;72:124-36.
Simpson G, Hopley P, Wilson J, Day N, Haworth A, Montazeri A, et al. Long-term outcomes of real world ‘watch and wait’ data for rectal cancer after neoadjuvant chemoradiotherapy. Colorectal Dis. 2020;22:1568-76.
Gerard JP, Chamorey E, Gourgou-Bourgade S, Benezery K, de Laroche G, Mahe MA, et al. Clinical complete response (cCR) after neoadjuvant chemoradiotherapy and conservative treatment in rectal cancer. Findings from the ACCORD 12/PRODIGE 2 randomized trial. Radiother Oncol. 2015;115(2):246-52.
Smith JJ, Strombom P, Chow OS, Roxburgh CS, Lynn P, Eaton A, et al. Assessment of a watch-and-wait strategy for rectal cancer in patients with a complete response after neoadjuvant therapy. JAMA Oncol. 2019;5(4):e185896.
Nasir I, Fernandez L, Vieira P, Pares O, Santiago I, Castillo-Martin M, et al. Salvage surgery for local regrowths in watch & wait - are we harming our patients by deferring the surgery? Eur J Surg Oncol. 2019;45(9):1559-66.
Habr-Gama A, Perez RO, Proscurshim I, Campos FG, Nadalin W, Kiss D, et al. Patterns of failure and survival for nonoperative treatment of stage c0 distal rectal cancer following neoadjuvant chemoradiation therapy. J Gastrointest Surg. 2006;10(10):1319-28; discussion 28-9.
Kong JC, Guerra GR, Warrier SK, Ramsay RG, Heriot AG. Outcome and salvage surgery following ‘watch and wait’ for rectal cancer after neoadjuvant therapy: a systematic review. Dis Colon Rectum. 2017;60(3):335-45.
Sao Juliao GP, Karagkounis G, Fernandez LM, Habr-Gama A, Vailati BB, Dattani M, et al. Conditional survival in patients with rectal cancer and complete clinical response managed by watch and wait after chemoradiation: recurrence risk over time. Ann Surg. 2020;272(1):138-44.
Emmertsen KJ, Laurberg S. Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg. 2012;255(5):922-8.
Downing A, Glaser AW, Finan PJ, Wright P, Thomas JD, Gilbert A, et al. Functional outcomes and health-related quality of life after curative treatment for rectal cancer: a population-level study in England. Int J Radiat Oncol Biol Phys. 2019;103(5):1132-42.
Pennings AJ, Kimman ML, Gielen AHC, Beets GL, Melenhorst J, Breukink SO. Burden of disease experienced by patients following a watch-and-wait policy for locally advanced rectal cancer: a qualitative study. Colorectal Dis. 2021;23(11):2870-8.
Haak HE, Zmuc J, Lambregts DMJ, Beets-Tan RGH, Melenhorst J, Beets GL, et al. The evaluation of follow-up strategies of watch-and-wait patients with a complete response after neoadjuvant therapy in rectal cancer. Colorectal Dis. 2021;23(7):1785-92.
Bregendahl S, Emmertsen KJ, Lindegaard JC, Laurberg S. Urinary and sexual dysfunction in women after resection with and without preoperative radiotherapy for rectal cancer: a population-based cross-sectional study. Colorectal Dis. 2015;17(1):26-37.
Stijns RCH, de Graaf EJR, Punt CJA, Nagtegaal ID, Nuyttens J, van Meerten E, et al. Long-term oncological and functional outcomes of chemoradiotherapy followed by organ-sparing transanal endoscopic microsurgery for distal rectal cancer: the CARTS study. JAMA Surg. 2019;154(1):47-54.
Custers PA, Hupkens BJP, Grotenhuis BA, Kuhlmann KFD, Breukink SO, Beets GL, et al. Selected stage IV rectal cancer patients managed by the watch-and-wait approach after pelvic radiotherapy: a good alternative to total mesorectal excision surgery? Colorectal Dis. 2022;24(4):401-10.
Lambregts DMJ, Maas M, Boellaard TN, Delli Pizzi A, van der Sande ME, Hupkens BJP, et al. Long-term imaging characteristics of clinical complete responders during watch-and-wait for rectal cancer-an evaluation of over 1500 MRIs. Eur Radiol. 2020;30(1):272-80.
Liu S, Zhong GX, Zhou WX, Xue HD, Pan WD, Xu L, et al. Can Endorectal ultrasound, MRI, and mucosa integrity accurately predict the complete response for mid-low rectal cancer after preoperative chemoradiation? A prospective observational study from a single medical center. Dis Colon Rectum. 2018;61(8):903-10.
Sclafani F, Brown G, Cunningham D, Wotherspoon A, Mendes LST, Balyasnikova S, et al. Comparison between MRI and pathology in the assessment of tumour regression grade in rectal cancer. Br J Cancer. 2017;117(10):1478-85.
Smith FM, Winter D. Watch and wait for rectal cancer: where are we really at? Colorectal Dis. 2014;16(5):332-4.
Park MJ, Kim SH, Lee SJ, Jang KM, Rhim H. Locally advanced rectal cancer: added value of diffusion-weighted MR imaging for predicting tumor clearance of the mesorectal fascia after neoadjuvant chemotherapy and radiation therapy. Radiology. 2011;260(3):771-80.
Schurink NW, Lambregts DMJ, Beets-Tan RGH. Diffusion-weighted imaging in rectal cancer: current applications and future perspectives. Br J Radiol. 2019;92(1096):20180655.
Patel UB, Blomqvist LK, Taylor F, George C, Guthrie A, Bees N, et al. MRI after treatment of locally advanced rectal cancer: how to report tumor response - the MERCURY experience. AJR Am J Roentgenol. 2012;199(4):W486-95.
Beets-Tan RGH, Lambregts DMJ, Maas M, Bipat S, Barbaro B, Curvo-Semedo L, et al. Magnetic resonance imaging for clinical management of rectal cancer: updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. Eur Radiol. 2018;28(4):1465-75.
Battersby NJ, Dattani M, Rao S, Cunningham D, Tait D, Adams R, et al. A rectal cancer feasibility study with an embedded phase III trial design assessing magnetic resonance tumour regression grade (mrTRG) as a novel biomarker to stratify management by good and poor response to chemoradiotherapy (TRIGGER): study protocol for a randomised controlled trial. Trials. 2017;18(1):394.
Santiago I, Barata M, Figueiredo N, Pares O, Henriques V, Galzerano A, et al. The split scar sign as an indicator of sustained complete response after neoadjuvant therapy in rectal cancer. Eur Radiol. 2020;30(1):224-38.
Montgomery v Lanarkshire Health Board [2015] UKSC 11 (11 March 2015).
Huh JW, Maeda K, Liu Z, Wang X, Roslani AC, Lee WY. Current status of ‘watch-and-wait’ rectal cancer treatment in Asia-Pacific countries. Ann Coloproctol. 2020;36:70-7.
Rao C, Sun Myint A, Athanasiou T, Faiz O, Martin AP, Collins B, et al. Avoiding radical surgery in elderly patients with rectal cancer is cost-effective. Dis Colon Rectum. 2017;60(1):30-42.
Miller JA, Wang H, Chang DT, Pollom EL. Cost-effectiveness and quality-adjusted survival of watch and wait after complete response to chemoradiotherapy for rectal cancer. J Natl Cancer Inst. 2020;112(8):792-801.
Hanly P, Ceilleachair AO, Skally M, O'Neill C, Sharp L. Direct costs of radiotherapy for rectal cancer: a microcosting study. BMC Health Serv Res. 2015;15:184.
Pellino G, Alos R, Biondo S, Codina-Cazador A, Enriquez-Navascues JM, Espin-Basany E, et al. Trends and outcome of neoadjuvant treatment for rectal cancer: a retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project. Eur J Surg Oncol. 2021;47(2):276-84.
Evans R, Taylor S, Janes S, Halligan S, Morton A, Navani N, et al. Patient experience and perceived acceptability of whole-body magnetic resonance imaging for staging colorectal and lung cancer compared with current staging scans: a qualitative study. BMJ Open. 2017;7(9):e016391.
Taylor SA, Mallett S, Miles A, Morris S, Quinn L, Clarke CS, et al. Whole-body MRI compared with standard pathways for staging metastatic disease in lung and colorectal cancer: the Streamline diagnostic accuracy studies. Health Technol Assess. 2019;23(66):1-270.
El Sissy C, Kirilovsky A, Van den Eynde M, Musina AM, Anitei MG, Romero A, et al. A diagnostic biopsy-adapted immunoscore predicts response to neoadjuvant treatment and selects patients with rectal cancer eligible for a watch-and-wait strategy. Clin Cancer Res. 2020;26(19):5198-207.
Bibault JE, Giraud P, Housset M, Durdux C, Taieb J, Berger A, et al. Deep learning and radiomics predict complete response after neo-adjuvant chemoradiation for locally advanced rectal cancer. Sci Rep. 2018;8(1):12611.
Boubaddi M, Fleming C, Vendrely V, Frulio N, Salut C, Rullier E, et al. Feasibility study of a response surveillance program in locally advanced mid and low rectal cancer to increase organ preservation. Eur J Surg Oncol. 2023;49(1):237-43.