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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

Authors

  • Angelita Habr-Gama

    1   Angelita & Joaquim Gama Institute, Sao Paulo, SP, Brazil
    2   University of Sao Paulo School of Medicine, Sao Paulo, SP, Brazil

  • Guilherme Pagin São Julião

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

  • Bruna Borba Vailati

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

  • Ivana Castro

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

  • Debora Raffaele

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

Publication History

Publication Date:
27 November 2017 (online)

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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