Abstract
Original language | English |
---|---|
Pages (from-to) | 401-410 |
Number of pages | 10 |
Journal | Colorectal disease |
Volume | 24 |
Issue number | 4 |
DOIs | |
Publication status | Published - 1 Apr 2022 |
Keywords
- metastatic disease
- oncological outcome
- organ-preservation
- rectal cancer
- watch-and-wait
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In: Colorectal disease, Vol. 24, No. 4, 01.04.2022, p. 401-410.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Selected stage IV rectal cancer patients managed by the watch-and-wait approach after pelvic radiotherapy
T2 - a good alternative to total mesorectal excision surgery?
AU - Custers, Petra A.
AU - Hupkens, Britt J. P.
AU - Grotenhuis, Brechtje A.
AU - Kuhlmann, Koert F. D.
AU - Breukink, Stéphanie O.
AU - Beets, Geerard L.
AU - Melenhorst, Jarno
AU - the Dutch Watch-and-Wait Consortium (collaborators)
AU - Beets-Tan, Regina G. H.
AU - Buijsen, Jeroen
AU - Festen, Sebastiaan
AU - de Graaf, Eelco J. R.
AU - Haak, Hester E.
AU - Hilling, Denise E.
AU - Hoff, Christiaan
AU - Intven, Martijn
AU - Komen, Niels
AU - Kusters, Miranda
AU - van Leerdam, Monique E.
AU - Peeters, Koen C. M. J.
AU - Peters, Femke P.
AU - Pronk, Apollo
AU - van der Sande, Marit E.
AU - Schreurs, Wilhelmina H.
AU - Sonneveld, Dirk J. A.
AU - Talsma, Aalbert K.
AU - Tuynman, Jurriaan B.
AU - Valkenburg-van Iersel, Liselot B. J.
AU - Vermaas, Maarten
AU - de Vos-Geelen, Judith
AU - van Westreenen, Henderik L.
AU - de Wilt, Johannes H. W.
AU - Zimmerman, David D. E.
N1 - Funding Information: There has been no financial support for this work. The authors thank the Dutch Watch-and-Wait Consortium (collaborators). Collaborators: Regina G. H. Beets-Tan, MD, PhD: Netherlands Cancer Institute, Department of Radiology, Amsterdam, The Netherlands; Jeroen Buijsen, MD, PhD: Maastricht University Medical Center, Department of Radiation Oncology (Maastro), Maastricht, The Netherlands and Maastricht University, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands; Sebastiaan Festen, MD, PhD: Onze Lieve Vrouwe Gasthuis, Department of Surgery, Amsterdam, The Netherlands; Eelco J. R. de Graaf, MD, PhD: IJsselland Hospital, Department of Surgery, Capelle aan de IJssel, The Netherlands; Hester E. Haak, MD: Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands; Denise E. Hilling, MD, PhD: Leiden University Medical Center, Department of Surgery, Leiden, The Netherlands and Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Oncological and Gastrointestinal Surgery, Rotterdam, The Netherlands; Christiaan Hoff, MD: Medical Center Leeuwarden, Department of Surgery, Leeuwarden, The Netherlands; Martijn Intven, MD, PhD: University Medical Center Utrecht, Department of Radiotherapy, Utrecht, The Netherlands; Niels Komen, MD, PhD: Antwerp University Hospital, Department of Abdominal Surgery, Edegem, Belgium and University of Antwerp, Antwerp Surgical Training, Anatomy and Research Center (ASTRAC), Wilrijk, Antwerp, Belgium; Miranda Kusters, MD, PhD: Amsterdam University Medical Centers, Location VUmc, Department of Surgery, Amsterdam, The Netherlands; Monique E. van Leerdam, MD, PhD: Netherlands Cancer Institute, Department of Gastroenterology, Amsterdam, The Netherlands and Leiden University Medical Center, Department of Gastroenterology, Leiden, The Netherlands; Koen C. M. J. Peeters, MD, PhD: Leiden University Medical Center, Department of Surgery, Leiden, The Netherlands; Femke P. Peters, MD, PhD: Netherlands Cancer Institute, Department of Radiotherapy, Amsterdam, The Netherlands and Leiden University Medical Center, Department of Radiotherapy, Leiden, The Netherlands; Apollo Pronk, MD, PhD: Diakonessenhuis, Department of Surgery, Utrecht, The Netherlands; Marit E. van der Sande, MD: Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands; Wilhelmina. H. Schreurs, MD, PhD: Noordwest Ziekenhuisgroep, Department of Surgery, Alkmaar, The Netherlands; Dirk J. A. Sonneveld, MD, PhD: Dijklander Hospital, Department of Surgery, Hoorn, The Netherlands; Aalbert K. Talsma, MD, PhD: Deventer Hospital, Department of Surgery, Deventer, The Netherlands; Jurriaan B. Tuynman, MD, PhD: Amsterdam University Medical Centers, Location VUmc, Department of Surgery, Amsterdam, The Netherlands; Liselot B. J. Valkenburg-van Iersel, MD, PhD: Maastricht University Medical Center, Department of Internal Medicine, Division of Medical Oncology, Maastricht, The Netherlands and Maastricht University, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands; Maarten Vermaas, MD, PhD: IJsselland Hospital, Department of Surgery, Capelle aan de IJssel, The Netherlands; Judith de Vos-Geelen, MD: Maastricht University Medical Center, Department of Internal Medicine, Division of Medical Oncology, Maastricht, The Netherlands and Maastricht University, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands; Henderik L. van Westreenen, MD, PhD: Isala, Department of Surgery, Zwolle, The Netherlands; Johannes H. W. de Wilt, MD, PhD: Radboud University Medical Center, Department of Surgery, Nijmegen, The Netherlands; David D. E. Zimmerman, MD, PhD: Elisabeth TweeSteden Hospital, Department of Surgery, Tilburg, The Netherlands. Publisher Copyright: © 2022 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Aim: The aim of this study was to assess the clinical and oncological outcome of a selected group of stage IV rectal cancer patients managed by the watch-and-wait approach following a (near-)complete response of the primary rectal tumour after radiotherapy. Method: Patients registered in the Dutch watch-and-wait registry since 2004 were selected when diagnosed with synchronous stage IV rectal cancer. Data on patient characteristics, treatment details, follow-up and survival were collected. The 2-year local regrowth rate, organ-preservation rate, colostomy-free rate, metastatic progression-free rate and 2- and 5-year overall survival were analysed. Results: After a median follow-up period of 35 months, local regrowth was observed in 17 patients (40.5%). Nine patients underwent subsequent total mesorectal excision, resulting in a permanent colostomy in four patients. The 2-year local regrowth rate was 39.9%, the 2-year organ-preservation rate was 77.1%, the 2-year colostomy-free rate was 88.1%, and the 2-year metastatic progression-free rate was 46.7%. The 2- and 5-year overall survival rates were 92.0% and 67.5%. Conclusion: The watch-and-wait approach can be considered as an alternative to total mesorectal excision in a selected group of stage IV rectal cancer patients with a (near-)complete response following pelvic radiotherapy. Despite a relatively high regrowth rate, total mesorectal excision and a permanent colostomy can be avoided in the majority of these patients.
AB - Aim: The aim of this study was to assess the clinical and oncological outcome of a selected group of stage IV rectal cancer patients managed by the watch-and-wait approach following a (near-)complete response of the primary rectal tumour after radiotherapy. Method: Patients registered in the Dutch watch-and-wait registry since 2004 were selected when diagnosed with synchronous stage IV rectal cancer. Data on patient characteristics, treatment details, follow-up and survival were collected. The 2-year local regrowth rate, organ-preservation rate, colostomy-free rate, metastatic progression-free rate and 2- and 5-year overall survival were analysed. Results: After a median follow-up period of 35 months, local regrowth was observed in 17 patients (40.5%). Nine patients underwent subsequent total mesorectal excision, resulting in a permanent colostomy in four patients. The 2-year local regrowth rate was 39.9%, the 2-year organ-preservation rate was 77.1%, the 2-year colostomy-free rate was 88.1%, and the 2-year metastatic progression-free rate was 46.7%. The 2- and 5-year overall survival rates were 92.0% and 67.5%. Conclusion: The watch-and-wait approach can be considered as an alternative to total mesorectal excision in a selected group of stage IV rectal cancer patients with a (near-)complete response following pelvic radiotherapy. Despite a relatively high regrowth rate, total mesorectal excision and a permanent colostomy can be avoided in the majority of these patients.
KW - metastatic disease
KW - oncological outcome
KW - organ-preservation
KW - rectal cancer
KW - watch-and-wait
UR - http://www.scopus.com/inward/record.url?scp=85126925301&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/codi.16034
DO - https://doi.org/10.1111/codi.16034
M3 - Article
C2 - 35060263
SN - 1462-8910
VL - 24
SP - 401
EP - 410
JO - Colorectal disease
JF - Colorectal disease
IS - 4
ER -