Guiding Patients Through a “Watch-and-Wait” Approach for Rectal Cancer—Understanding the Functional Outcomes
Menée auprès de 278 patients atteints d'un cancer du rectum et ayant une réponse clinique complète après une chimioradiothérapie néoadjuvante ou une radiothérapie (67 % d'hommes ; âge médian : 66 ans), cette étude analyse la qualité de vie et les résultats fonctionnels des patients lors d'une approche de surveillance de type "watch and wait"
Historically, treatment for rectal cancer mandated proctectomy and chemoradiotherapy. With the shift to neoadjuvant chemoradiation, some patients were noted to have a complete clinical response, which led to select patients being offered nonoperative, surveillance-intensive management called “watch and wait.” Suitable candidates have a low or midrectal cancer, have completed chemoradiation therapy, and have demonstrated complete regression on clinical examination. Although oncologic outcomes have been investigated intensely, less has been studied regarding functional outcomes. Smaller studies have demonstrated lower rates of bowel dysfunction, and many clinicians counsel patients that preservation of the rectum protects against the significant bowel, bladder, and sexual dysfunction often accompanying proctectomy.
JAMA Surgery , éditorial, 2022