Read by QxMD icon Read

Watch and wait cancer rectal

Aiwen Wu, Lin Wang, Changzheng Du, Yifan Peng, Yunfeng Yao, Jun Zhao, Tiancheng Zhan, Yong Cai, Yongheng Li, Yingshi Sun, Jiafu Ji
OBJECTIVE: To investigate the safety and efficacy of organ preservation surgery or "watch and wait" strategy for rectal cancer patients who are evaluated as clinical complete response(cCR) or near-cCR following neoadjuvant chemoradiotherapy (nCRT). METHOD: From March 2011 to June 2016, 35 patients with mid-low rectal cancers who were diagnosed as cCR or near-cCR following nCRT underwent organ preservation surgery with local excision or surveillance following "watch and wait" strategy in the Peking University Cancer Hospital...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Tarik Sammour, Brandee A Price, Kate J Krause, George J Chang
BACKGROUND: There is increasing interest in nonoperative management (NOM) for rectal cancer with complete clinical response (cCR) after neoadjuvant chemoradiation (nCRT). OBJECTIVE: The aim of this systematic review was to summarize the available data on NOM, with the intention of formulating standardized protocols on which to base future investigations. METHODS: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted...
March 21, 2017: Annals of Surgical Oncology
Kazushige Kawai, Soichiro Ishihara, Hiroaki Nozawa, Keisuke Hata, Tomomichi Kiyomatsu, Teppei Morikawa, Masashi Fukayama, Toshiaki Watanabe
BACKGROUND: Nonoperative management for patients with rectal cancer who have achieved a clinical complete response after chemoradiotherapy is becoming increasingly important in recent years. However, the definition of and modality used for patients with clinical complete response differ greatly between institutions, and the role of endoscopic assessment as a nonoperative approach has not been fully investigated. OBJECTIVE: This study aimed to investigate the ability of endoscopic assessments to predict pathological regression of rectal cancer after chemoradiotherapy and the applicability of these assessments for the watchful waiting approach...
April 2017: Diseases of the Colon and Rectum
Bengt Glimelius
Preoperative radiotherapy (RT) or chemoradiotherapy (CRT) is often required before rectal cancer surgery to obtain low local recurrence rates or, in locally advanced tumours, to radically remove the tumour. RT/CRT in tumours responding completely can allow an organ-preserving strategy. The time from the end of the RT/CRT to surgery or to the decision not to operate has been prolonged during recent years. After a brief review of the literature, the relevance of the time interval to surgery is discussed depending upon the indication for RT/CRT...
March 2017: Upsala Journal of Medical Sciences
Joseph C Kong, Glen R Guerra, Satish K Warrier, Robert G Ramsay, Alexander G Heriot
BACKGROUND: Currently there is no reliable test to predict pathological complete response following neoadjuvant chemoradiotherapy for rectal cancer. However, there is increasing interest in using clinical complete response as a surrogate marker, allowing a subset of patients with locally advanced rectal cancer to be allocated into a "watch and wait" pathway. Little is known about the oncological safety of the "watch and wait" approach or the rate of salvage surgery in cases of tumor regrowth...
March 2017: Diseases of the Colon and Rectum
B Creavin, E Ryan, S T Martin, A Hanly, P R O'Connell, K Sheahan, D C Winter
BACKGROUND: Organ preservation has been proposed as an alternative to radical surgery for rectal cancer to reduce morbidity and mortality, and to improve functional outcome. METHODS: Locally advanced non-metastatic rectal cancers were identified from a prospective database. Patients staged ⩾T3 or any stage N+ were referred for neoadjuvant chemoradiotherapy (CRT) (50-54 Gy and 5-fluorouracil), and were reassessed 6-8 weeks post treatment. An active surveillance programme ('watch and wait') was offered to patients who were found to have a complete endoluminal response...
January 17, 2017: British Journal of Cancer
Christopher Rao, Arthur Sun Myint, Thanos Athanasiou, Omar Faiz, Antony Paul Martin, Brendan Collins, Fraser McLean Smith
BACKGROUND: Radical surgery is associated with significant perioperative mortality in elderly and comorbid populations. Emerging data suggest for patients with a clinical complete response after neoadjuvant chemoradiotherapy that a watch-and-wait approach may provide equivalent survival and oncological outcomes. OBJECTIVE: The purpose of this study was to compare the cost-effectiveness of watch and wait and radical surgery for patients with rectal cancer after a clinical complete response following chemoradiotherapy...
January 2017: Diseases of the Colon and Rectum
Geerard L Beets, Nuno F Figueiredo, Regina G H Beets-Tan
The basis of the current treatment of rectal cancer is a radical total mesorectal excision of the rectum, and although this provides excellent oncological control, it is associated with morbidity and functional problems in cancer survivors. Organ-preservation alternatives are local excision alone for very early tumors, chemoradiation followed by either local excision of a small tumor remnant or, when there is a complete clinical response, a nonoperative watch-and-wait approach. The functional advantage of these alternatives is clear, but there is some concern about the oncological risk...
January 14, 2017: Annual Review of Medicine
Milou H Martens, Monique Maas, Luc A Heijnen, Doenja M J Lambregts, Jeroen W A Leijtens, Laurents P S Stassen, Stephanie O Breukink, Christiaan Hoff, Eric J Belgers, Jarno Melenhorst, Rob Jansen, Jeroen Buijsen, Ton G M Hoofwijk, Regina G H Beets-Tan, Geerard L Beets
BACKGROUND: The aim of this study was to establish the oncological and functional results of organ preservation with a watch-and-wait approach (W&W) and selective transanal endoscopic microsurgery (TEM) in patients with a clinical complete or near-complete response (cCR) after neoadjuvant chemoradiation for rectal cancer. METHODS: Between 2004 and 2014, organ preservation was offered if response assessment with digital rectal examination, endoscopy, and MRI showed (near) cCR...
December 2016: Journal of the National Cancer Institute
Ivana M Blazic, Naomi M Campbell, Marc J Gollub
MRI plays an increasingly pivotal role in the clinical staging of rectal cancer in the baseline and post-treatment settings. An accurate evaluation of response to neoadjuvant treatment is crucial because of its major influence on patient management and quality of life. However, evaluation of treatment response is challenging for both imaging and clinical assessments owing to treatment-related inflammation and fibrosis. At one end of the spectrum are clinical yT4 rectal cancers, wherein precise post-treatment MRI evaluation of tumour spread is particularly important for avoiding unnecessary exenterative surgery...
August 2016: British Journal of Radiology
M Kusters, A Slater, M Betts, R Hompes, R J Guy, O M Jones, B D George, I Lindsey, N J Mortensen, D R James, C Cunningham
AIM: Outcomes following treatment for low rectal cancer still remain inferior to those for upper rectal cancer. A clear definition of 'low' rectal cancer is lacking and consensus is more likely using a definition based on MRI criteria. This study aimed to determine disease presentation and treatment outcome of low rectal cancer based on a strict anatomical definition. METHOD: A low rectal cancer was defined as one with a lower border below the pelvic attachment of the levator muscles on sagittal MRI...
November 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Mohamed E Salem, Marion Hartley, Keith Unger, John L Marshall
Rectal cancer treatment presents a challenge, and its optimal management requires a multidisciplinary approach involving surgical, medical, and radiation oncologists. Advances in surgical techniques, radiotherapy, and medical imaging technology have transformed the therapeutic landscape and have led to substantial improvements in both local disease control and patient survival. The currently established standard of care for patients with locally advanced rectal cancer involves preoperative (neoadjuvant) concurrent radiotherapy and infusional fluorouracil-based or oral capecitabine-based chemotherapy, also known as chemoradiotherapy (CRT), followed by surgery...
June 2016: Oncology (Williston Park, NY)
Karyn A Goodman
Preoperative chemoradiotherapy (CRT) followed by total mesorectal excision has been the standard of care for locally advanced patients with rectal cancer. Some patients achieve a pathologic complete response (pCR) to CRT and the oncologic outcomes are particularly favorable in this group. The role of surgery in patients with a pCR is now being questioned as radical rectal resection is associated with significant morbidity and long-term effects on quality of life. In an attempt to better tailor therapy, there is an interest in a "watch-and-wait" approach in patients who have a clinical complete response (cCR) after CRT with the goal of omitting surgery and allowing for organ preservation...
July 2016: Seminars in Radiation Oncology
Azadeh Azizian, Jens Gruber, B Michael Ghadimi, Jochen Gaedcke
In rectal cancer, one of the most common cancers worldwide, the proper staging of the disease determines the subsequent therapy. For those with locally advanced rectal cancer, a neoadjuvant chemoradiotherapy (CRT) is recommended before any surgery. However, response to CRT ranges from complete response (responders) to complete resistance (non-responders). To date we are not able to separate in advance the first group from the second, due to the absence of a valid biomarker. Therefore all patients receive the same therapy regardless of whether they reap benefits...
May 15, 2016: World Journal of Gastrointestinal Oncology
Erika M Noonan, Timothy W Farrell
This summary of the American Cancer Society Prostate Cancer Survivorship Care Guidelines targets primary care physicians who coordinate care of prostate cancer survivors with subspecialists. Prostate cancer survivors should undergo prostate-specific antigen screening every six to 12 months and digital rectal examination annually. Surveillance of patients who choose watchful waiting for their prostate cancer should be conducted by a subspecialist. Any hematuria or rectal bleeding must be thoroughly evaluated...
May 1, 2016: American Family Physician
Alexander T Hawkins, Steven R Hunt
Despite decades of high-quality research, the treatment of rectal cancer remains a work in progress. The interplay between chemotherapy, radiotherapy, and surgery is under constant rearrangement and refinement. Through this all, the desire to preserve the anal sphincters and quality of life remains at the forefront. In the past decade, standard of care for stage II or III rectal cancers in the USA has been neoadjuvant chemoradiation therapy (CRT) followed by radical surgical resection of the rectum. While timing and sequence of the CRT continues to evolve, surgical resection has remained essential in treatment...
May 2016: Current Treatment Options in Oncology
Oliver S Chow, Deborah Kuk, Metin Keskin, J Joshua Smith, Niedzica Camacho, Raphael Pelossof, Chin-Tung Chen, Zhenbin Chen, Karin Avila, Martin R Weiser, Michael F Berger, Sujata Patil, Emily Bergsland, Julio Garcia-Aguilar
BACKGROUND: The response of rectal cancers to neoadjuvant chemoradiation (CRT) is variable, but tools to predict response remain lacking. We evaluated whether KRAS and TP53 mutations are associated with pathologic complete response (pCR) and lymph node metastasis after adjusting for neoadjuvant regimen. METHODS: Retrospective analysis of 229 pretreatment biopsies from patients with stage II/III rectal cancer was performed. All patients received CRT. Patients received 0-8 cycles of FOLFOX either before or after CRT, but prior to surgical excision...
August 2016: Annals of Surgical Oncology
M Dattani, B J Moran
No abstract text is available yet for this article.
May 2016: British Journal of Surgery
Carlos Alberto Vaccaro, Federico Julio Yazyi, Guillermo Ojra Quintana, Juan Pablo Santino, Mabel Edith Sardi, Damián Beder, Joaquin Tognelli, Fernando Bonadeo, José María Lastiri, Gustavo Leandro Rossi
INTRODUCTION: The standard treatment for locally advanced rectal cancer is total mesorectal excision. However, organ preservation has been proposed for tumors with good response to neoadjuvant treatment. The aim of this study was to evaluate the oncologic results of this strategy. METHODS: This is a retrospective cohort study (2005-2014) including a consecutive series of patients with rectal adenocarcinoma with complete or almost complete clinical response after preoperative chemo-radiotherapy, that were treated according to a strategy of preservation of the rectum...
May 2016: Cirugía Española
Robin Krol, Robert J Smeenk, Emile N J T van Lin, Wim P M Hopman
Prostate cancer is the most common cancer in Dutch men and has a relatively good survival rate. Anorectal symptoms after irradiation of the prostate, including rectal blood loss and faecal incontinence, can have a serious impact on quality of life. On endoscopy, the Vienna Rectoscopy Score may reveal telangiectasia or other mucosal changes, but there may also be other causes of blood loss. Endoscopy or watchful waiting can be considered in patients with rectal bleeding. Sucralfate enemas, argon plasma coagulation and hyperbaric oxygen therapy are effective treatments...
2015: Nederlands Tijdschrift Voor Geneeskunde
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"