Management of the Complete Clinical Response

Angelita Habr-Gama; Guilherme Pagin São Julião; Bruna Borba Vailati; Ivana Castro; Debora Raffaele

doi:10.1055/s-0037-1606116

Clinics in Colon and Rectal Surgery, Table of Contents

Clin Colon Rectal Surg 2017; 30(05): 387-394
DOI: 10.1055/s-0037-1606116

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of the Complete Clinical Response

Angelita Habr-Gama

¹Angelita & Joaquim Gama Institute, Sao Paulo, SP, Brazil

²University of Sao Paulo School of Medicine, Sao Paulo, SP, Brazil

,

Guilherme Pagin São Julião

¹Angelita & Joaquim Gama Institute, Sao Paulo, SP, Brazil

,

Bruna Borba Vailati

¹Angelita & Joaquim Gama Institute, Sao Paulo, SP, Brazil

,

Ivana Castro

¹Angelita & Joaquim Gama Institute, Sao Paulo, SP, Brazil

,

Debora Raffaele

¹Angelita & Joaquim Gama Institute, Sao Paulo, SP, Brazil

› Author Affiliations

Abstract

Organ preservation is considered in the management of selected patients with rectal cancer. Complete clinical response observed after neoadjuvant chemoradiation for rectal cancer is one of these cases. Patients who present complete clinical response are candidates to the watch-and-wait approach, when radical surgery is not immediately performed and is offered only to patients in the event of a local relapse. These patients are included in a strict follow-up, and up of 70% of them will never be operated during the follow-up. This strategy is associated with similar oncological outcomes as patients operated on, and the advantage of avoiding the morbidity associated to the radical operation. In this article we will discuss in detail the best candidates for this approach, the protocol itself, and the long-term outcomes.

Keywords

rectal cancer - complete response - neoadjuvant therapy - watch-and-wait

Full Text

References

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