Watch and wait in rectal cancer: is it time to subclassify cT3?
A partir d'une revue systématique de la littérature publiée entre janvier 2016 et mai 2017 (11 études incluant au total 602 patients), cette méta-analyse identifie les facteurs associés à la reprise de la croissance tumorale chez les patients atteints d'un cancer rectal et bénéficiant d'une surveillance médicale après une chimioradiothérapie néo-adjuvante ayant stabilisé la tumeur
Traditional concepts regarding the optimum management of locally advanced rectal cancer are evolving. Preoperative chemoradiotherapy is the standard of care worldwide. In randomised trials, a pathological complete response is achieved in 10–20% of patients after chemoradiotherapy, and in retrospective series a complete clinical response is achieved in 20–50%. 1 , 2 Increasingly, patients who achieve clinical complete response are being considered for organ-preserving strategies such as watch and wait. Avoidance of major surgery reduces morbidity, mortality, and the functional consequences of surgery and subsequent stoma-related complications. The benefit and safety of this approach compared with radical surgery has been supported mainly by single-centre studies.