Wait and see approach for rectal cancer with a clinically complete response after neoadjuvant concurrent chemoradiotherapy
03 medical and health sciences
Treatment Outcome
0302 clinical medicine
Rectal Neoplasms
Rectum
Humans
Chemoradiotherapy
Watchful Waiting
Neoadjuvant Therapy
3. Good health
DOI:
10.1007/s00384-016-2709-0
Publication Date:
2016-11-24T05:06:54Z
AUTHORS (9)
ABSTRACT
Rectal cancer patients with a pathological complete response (pCR) after neoadjuvant concurrent chemoradiotherapy (CCRT) have a better prognosis compared to those without a pCR. Therefore, the "Wait and See" (W&S) approach in those who achieved clinically complete response (cCR) after CCRT was introduced as an alternative modality to the total mesorectal excision (TME). The aim of this study was to compare the oncological outcomes between W&S and TME via meta-analysis.We performed a comprehensive literature search on January 14, 2016, using MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus. In addition, the references of all articles obtained were searched manually. The qualities of each study were assessed using the Newcastle-Ottawa quality assessment scale. The main outcomes were recurrence, disease-free survival (DFS), and overall survival (OS). We calculated the risk ratio (RR) and hazard ratio (HR) for the recurrence and survival rates, respectively.The RR of patients whose initial recurrences was local recurrence (LR), distant metastasis (DM), LR + DM, or overall recurrences were 0.18, 1.00, 0.61, and 0.49, respectively. There was no heterogeneity in the results. The HR of DFS was 0.59 and indicated that DFS in the TME group was superior compared with that in the W&S group. The OS has no significant difference between the studies.Although the W&S approach seemed feasible for rectal cancer patients with a cCR after neoadjuvant CCRT, concrete evidence obtained in well-controlled randomized trials with a long-term follow-up is required to validate potential treatment options.
SUPPLEMENTAL MATERIAL
Coming soon ....
REFERENCES (12)
CITATIONS (8)
EXTERNAL LINKS
PlumX Metrics
RECOMMENDATIONS
FAIR ASSESSMENT
Coming soon ....
JUPYTER LAB
Coming soon ....