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JOURNAL ARTICLE
Carine El Sissy, Amos Kirilovsky, Christine Lagorce Pagès, Florence Marliot, Petra A Custers, Edina Dizdarevic, Marine Sroussi, Mireia Castillo-Martin, Nacilla Haicheur, Mohamed Dermani, Nicolas Loche, Bénedicte Buttard, Ana Maria Musina, Maria Gabriela Anitei, José G van den Berg, Annegien Broeks, Soledad Iseas, Mariana Coraglio, Fernando Sanchez Loria, Alfredo Romero, Pierre Laurent-Puig, Aurélien de Reyniès, Laura M Fernandez, Mehdi Karoui, David Tougeron, Carlos A Vaccaro, Juan P Santino, Laurids Østergaard Poulsen, Jan Lindebjerg, Juan Manuel O'Connor, Viorel Scripcariu, Mihail-Gabriel Dimofte, Jean-Pierre Gérard, Myriam Chalabi, Nuno Figueiredo, Rodrigo O Perez, Angelita Habr-Gama, Jérôme Galon, Torben Frøstrup Hansen, Lars Henrik Jensen, Geerard Beets, Guy Zeitoun, Franck Pagès
PURPOSE: No biomarker capable of improving selection and monitoring of patients with rectal cancer managed by watch-and-wait (W&W) strategy is currently available. Prognostic performance of the Immunoscore biopsy (ISB ) was recently suggested in a preliminary study. METHODS: This international validation study included 249 patients with clinical complete response (cCR) managed by W&W strategy. Intratumoral CD3+ and CD8+ T cells were quantified on pretreatment rectal biopsies by digital pathology and converted to ISB ...
January 1, 2024: Journal of Clinical Oncology
#2
LETTER
Laura M Fernandez, Guilherme P São Julião, Andrew G Renehan, Geerard L Beets, Ana L Papoila, Bruna B Vailati, Elma Meershoek-Klein Kranenbarg, Annet G H Roodvoets, Nuno L Figueiredo, Cornelis J H Van De Velde, Angelita Habr-Gama, Rodrigo O Perez
No abstract text is available yet for this article.
October 1, 2023: Diseases of the Colon and Rectum
#3
JOURNAL ARTICLE
Guilherme Pagin São Julião, Laura M Fernández, Bruna Borba Vailati, Angelita Habr-Gama, José Azevedo, Inês Santiago, Oriol Parés, Amjad Parvaiz, Véronique Vendrely, Anne Rullier, Eric Rullier, Quentin Denost, Rodrigo Oliva Perez
BACKGROUND: A proportion of patients that achieve a clinical complete response may develop local regrowth. While salvage appears to provide appropriate local control, the risk of distant metastases is less known. OBJECTIVE: Compare the risk of distant metastases between patients that achieve a complete clinical response (watch-and-wait strategy) and subsequent local regrowth to patients managed by surgery after chemoradiation. DESIGN: Retrospective multicenter cohort study...
July 25, 2023: Diseases of the Colon and Rectum
#4
RANDOMIZED CONTROLLED TRIAL
Angelita Habr-Gama, Guilherme Pagin São Julião, Cinthia D Ortega, Bruna Borba Vailati, Sergio Araujo, Thiago Jorge, Jorge Sabbaga, Gustavo L Rossi, Renata D'Alpino, Fabio Roberto Kater, Patricia Bailão Aguilar, Adrian Mattacheo, Rodrigo Oliva Perez
BACKGROUND: Neoadjuvant chemoradiation(nCRT) has been considered the preferred initial treatment strategy for distal rectal cancer. Advantages of this approach include improved local control after radical surgery but also the opportunity for organ preserving strategies (Watch and Wait-WW). Consolidation chemotherapy(cCT) regimens using fluoropyrimidine-based with or without oxalipatin following nCRT have demonstrated to increase complete response and organ preservation rates among these patients...
June 14, 2023: BMC Cancer
#5
REVIEW
Carlos Cerdan-Santacruz, Guilherme Pagin São Julião, Bruna Borba Vailati, Leonardo Corbi, Angelita Habr-Gama, Rodrigo Oliva Perez
The administration of neoadjuvant chemoradiotherapy (nCRT) followed by total mesorrectal excision (TME) and selective use of adjuvant chemotherapy can still be considered the standard of care in locally advanced rectal cancer (LARC). However, avoiding sequelae of TME and entering a narrow follow-up program of watch and wait (W&W), in select cases that achieve a comparable clinical complete response (cCR) to nCRT, is now very attractive to both patients and clinicians. Many advances based on well-designed studies and long-term data coming from big multicenter cohorts have drawn some important conclusions and warnings regarding this strategy...
April 14, 2023: Journal of Clinical Medicine
#6
MULTICENTER STUDY
Laura M Fernandez, Guilherme P São Julião, Andrew G Renehan, Geerard L Beets, Ana L Papoila, Bruna B Vailati, Renu R Bahadoer, Elma Meershoek-Klein Kranenbarg, Annet G H Roodvoets, Nuno L Figueiredo, Cornelis J H Van De Velde, Angelita Habr-Gama, Rodrigo O Perez
BACKGROUND: Nearly 30% of patients with rectal cancer develop local regrowth after initial clinical complete response managed by watch and wait. These patients might be at higher risk for distant metastases. OBJECTIVE: This study aimed to investigate risk factors for distant metastases using time-dependent analyses. DESIGN: Data from an international watch and wait database were retrospectively reviewed. Cox regression analysis was used to determine risk factors for worse distant metastases-free survival...
January 1, 2023: Diseases of the Colon and Rectum
#7
REVIEW
C Cerdán-Santacruz, B B Vailati, G P São Julião, A Habr-Gama, R O Perez
Organ preservation strategies, especially watch and wait, after neoadjuvant treatment in locally advanced rectal cancer, have become topics that generate significant interest, for both patients and clinicians. The obvious advantage of these strategies is the avoidance of surgery with its associated risks and functional consequences. Over time, it has become evident that these strategies offer acceptable safety in oncological terms and, in most patients, allows preservation of the rectum without harming patients in terms of distant metastasis or survival...
August 20, 2022: Techniques in Coloproctology
#8
REVIEW
Carlos Cerdán-Santacruz, Bruna B Vailati, Gillherme P São Julião, Angelita Habr-Gama, Rodrigo O Perez
The current standard of care for the treatment of locally advanced rectal cancer includes neoadjuvant chemoradiation (nCRT) followed by total mesorrectal excision (TME). The observation of significant primary tumor response to radiation and chemotherapy led to the idea of organ-preserving strategies in selected patients who achieved clinical, endoscopic and radiological evidence of complete tumor regression. One of these strategies includes no immediate surgery with close surveillance, known as the Watch and Wait strategy (W&W)...
August 2022: Surgical Oncology
#9
REVIEW
Bruna Borba Vailati, Guilherme Pagin São Julião, Angelita Habr-Gama, Rodrigo Oliva Perez
In recent decades, rectal cancer management has become increasingly challenging for multiple reasons. Proper imaging using dedicated magnetic resonance, standardization of total mesorectal excision, and incorporation of neoadjuvant treatment regimens have contributed to a significant decrease in local recurrence rates. The observation of complete tumor response to radiation or chemoradiation led to the proposal of organ-preservation strategies with avoidance of immediate surgery and close surveillance (Watch and Wait strategy) in selected patients...
April 2022: Surgical Oncology Clinics of North America
#10
JOURNAL ARTICLE
Amos Kirilovsky, Carine El Sissy, Guy Zeitoun, Florence Marliot, Nacilla Haicheur, Christine Lagorce-Pagès, Julien Taieb, Mehdi Karoui, Petra Custers, Edina Dizdarevic, Soledad Iseas, Torben Frøstrup Hansen, Lars Henrik Jensen, Geerard Beets, Jean Pierre Gérard, Mireia Castillo-Martin, Nuno Figueiredo, Angelita Habr-Gama, Rodrigo Perez, Jérôme Galon, Franck Pagès
Because of the function and anatomical environment of the rectum, therapeutic strategies for local advanced rectal cancer (LARC) must deal with two challenging stressors that are a high-risk of local and distal recurrences and a high-risk of poor quality of life (QoL). Over the last three decades, advances in screening tests, therapies, and combined-modality treatment options and strategies have improved the prognosis of patients with LARC. However, owing to the heterogeneous nature of LARC and genetic status, the patient may not respond to a specific therapy and may be at increased risk of side-effects without the life-prolonging benefit...
2022: Oncotarget
#11
JOURNAL ARTICLE
Lucas F Sobrado, Rodrigo A Pinto, Sergio C Nahas
No abstract text is available yet for this article.
February 1, 2022: Diseases of the Colon and Rectum
#12
JOURNAL ARTICLE
Bruna Borba Vailati, Guilherme P São Julião, Adrian Mattacheo, Angelita Habr-Gama, Tsuyoshi Konishi, Rodrigo Oliva Perez
No abstract text is available yet for this article.
February 1, 2022: Diseases of the Colon and Rectum
#13
JOURNAL ARTICLE
Orlando Jorge Torres, Savio George Barreto
No abstract text is available yet for this article.
November 16, 2021: World Journal of Surgery
#14
JOURNAL ARTICLE
Laura M Fernandez, Nuno Figueiredo, Angelita Habr-Gama, Guilherme P São Julião, Pedro Vieira, Bruna B Vailati, Irfan Nasir, Oriol Parés, Inês Santiago, Mireia Castillo-Martin, Carlos Carvalho, Amjad Parvaiz, Rodrigo O Perez
No abstract text is available yet for this article.
October 8, 2021: Diseases of the Colon and Rectum
#15
MULTICENTER STUDY
Renu R Bahadoer, Koen C M J Peeters, Geerard L Beets, Nuno L Figueiredo, Esther Bastiaannet, Alexander Vahrmeijer, Sofieke J D Temmink, W M Elma Meershoek-Klein Kranenbarg, Annet G H Roodvoets, Angelita Habr-Gama, Rodrigo O Perez, Cornelis J H van de Velde, Denise E Hilling
BACKGROUND: Young-onset rectal cancer, in patients less than 50 years, is expected to increase in the coming years. A watch-and-wait strategy is nowadays increasingly practised in patients with a clinical complete response (cCR) after neoadjuvant treatment. Nevertheless, there may be reluctance to offer organ preservation treatment to young patients owing to a potentially higher oncological risk. This study compared patients aged less than 50 years with those aged 50 years or more to identify possible differences in oncological outcomes of watch and wait...
December 17, 2021: British Journal of Surgery
#16
LETTER
Laura M Fernandez, Nuno L Figueiredo, Angelita Habr-Gama, Guilherme P São Julião, Pedro Vieira, Bruna B Vailati, Irfan Nasir, Oriol Parés, Inês Santiago, Mireia Castillo-Martin, Carlos Carvalho, Amjad Parvaiz, Rodrigo O Perez
No abstract text is available yet for this article.
May 2021: Diseases of the Colon and Rectum
#17
JOURNAL ARTICLE
Laura M Fernandez, Nuno L Figueiredo, Angelita Habr-Gama, Guilherme P São Julião, Pedro Vieira, Bruna B Vailati, Irfan Nasir, Oriol Parés, Inês Santiago, Mireia Castillo-Martin, Carlos Carvalho, Amjad Parvaiz, Rodrigo O Perez
No abstract text is available yet for this article.
February 18, 2021: Diseases of the Colon and Rectum
#18
MULTICENTER STUDY
Laura M Fernandez, Guilherme P São Julião, Nuno L Figueiredo, Geerard L Beets, Maxime J M van der Valk, Renu R Bahadoer, Denise E Hilling, Elma Meershoek-Klein Kranenbarg, Annet G H Roodvoets, Andrew G Renehan, Cornelis J H van de Velde, Angelita Habr-Gama, Rodrigo O Perez
BACKGROUND: Watch and wait is a novel management strategy in patients with rectal cancer who have a clinical complete response after neoadjuvant chemoradiotherapy. Surveillance of these patients is generally intensive, because local regrowth (with the potential for salvage) occurs in 25% of patients, and distant metastases occur in 10% of patients. It is unclear for how long these patients should be followed up. To address this issue, we did conditional survival modelling using the International Watch & Wait Database (IWWD), which is a large-scale registry of patients with a clinical complete response after neoadjuvant chemotherapy who have been managed by a watch-and-wait strategy...
January 2021: Lancet Oncology
#19
REVIEW
Laura Melina Fernandez, Guilherme Pagin São Julião, Bruna Borba Vailati, Angelita Habr-Gama, Rodrigo Oliva Perez
The possibility of organ preservation in early rectal cancer has gained popularity during recent years. Patients with early tumor stage and low risk for local recurrence do not usually require neoadjuvant chemoradiation for oncological reasons. However, these patients may be considered for chemoradiation exclusively for the purpose of achieving a complete clinical response and avoid total mesorectal excision. In addition, cT2 tumors may be more likely to develop complete response to neoadjuvant therapy and may constitute ideal candidates for organ-preserving strategies...
November 2020: Clinics in Colon and Rectal Surgery
#20
JOURNAL ARTICLE
Laura M Fernandez, Nuno L Figueiredo, Angelita Habr-Gama, Guilherme P São Julião, Pedro Vieira, Bruna B Vailati, Irfan Nasir, Oriol Parés, Inês Santiago, Mireia Castillo-Martin, Carlos Carvalho, Amjad Parvaiz, Rodrigo Oliva Perez
BACKGROUND: Patients with rectal cancer who achieve complete clinical response after neoadjuvant chemoradiation have been managed nonoperatively. Thirty percent of these patients may develop a local regrowth, and salvage resection with radical surgery is usually recommended. However, selected patients could be offered additional organ preservation by local excision. We hypothesized that patients with baseline T2 who underwent neoadjuvant therapy (for the specific purpose of achieving a complete clinical response) were more likely to harbor recurrent disease at an earlier stage and amenable to organ preservation strategies (local excision) when compared with T3/T4 (undergoing neoadjuvant chemoradiation for oncologic reasons)...
August 2020: Diseases of the Colon and Rectum
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