Watch and wait after neoadjuvant treatment in rectal cancer: comparison of outcomes in patients with and without a complete response at first reassessment in the International Watch & Wait Database (IWWD)
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.26/47631 |
Resumo: | Background: In rectal cancer, watch and wait for patients with a cCR after neoadjuvant treatment has an established evidence base. However, there is a lack of consensus on the definition and management of a near-cCR. This study aimed to compare outcomes in patients who achieved a cCR at first reassessment versus later reassessment. Methods: This registry study included patients from the International Watch & Wait Database. Patients were categorized as having a cCR at first reassessment or at later reassessment (that is near-cCR at first reassessment) based on MRI and endoscopy. Organ preservation, distant metastasis-free survival, and overall survival rates were calculated. Subgroup analyses were done for near-cCR groups based on the response evaluation according to modality. Results: A total of 1010 patients were identified. At first reassessment, 608 patients had a cCR; 402 had a cCR at later reassessment. Median follow-up was 2.6 years for patients with a cCR at first reassessment and 2.9 years for those with a cCR at later reassessment. The 2-year organ preservation rate was 77.8 (95 per cent c.i. 74.2 to 81.5) and 79.3 (75.1 to 83.7) per cent respectively (P = 0.499). Similarly, no differences were found between groups in distant metastasis-free survival or overall survival rate. Subgroup analyses showed a higher organ preservation rate in the group with a near-cCR categorized exclusively by MRI. Conclusion: Oncological outcomes for patients with a cCR at later reassessment are no worse than those of patients with a cCR at first reassessment. |
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Watch and wait after neoadjuvant treatment in rectal cancer: comparison of outcomes in patients with and without a complete response at first reassessment in the International Watch & Wait Database (IWWD)Neoplasias Colorrectais/tratamentoTerapia NeoadjuvanteConduta ExpectanteRectal Neoplasms/therapyRectal Neoplasms/therapyWatchful WaitingBackground: In rectal cancer, watch and wait for patients with a cCR after neoadjuvant treatment has an established evidence base. However, there is a lack of consensus on the definition and management of a near-cCR. This study aimed to compare outcomes in patients who achieved a cCR at first reassessment versus later reassessment. Methods: This registry study included patients from the International Watch & Wait Database. Patients were categorized as having a cCR at first reassessment or at later reassessment (that is near-cCR at first reassessment) based on MRI and endoscopy. Organ preservation, distant metastasis-free survival, and overall survival rates were calculated. Subgroup analyses were done for near-cCR groups based on the response evaluation according to modality. Results: A total of 1010 patients were identified. At first reassessment, 608 patients had a cCR; 402 had a cCR at later reassessment. Median follow-up was 2.6 years for patients with a cCR at first reassessment and 2.9 years for those with a cCR at later reassessment. The 2-year organ preservation rate was 77.8 (95 per cent c.i. 74.2 to 81.5) and 79.3 (75.1 to 83.7) per cent respectively (P = 0.499). Similarly, no differences were found between groups in distant metastasis-free survival or overall survival rate. Subgroup analyses showed a higher organ preservation rate in the group with a near-cCR categorized exclusively by MRI. Conclusion: Oncological outcomes for patients with a cCR at later reassessment are no worse than those of patients with a cCR at first reassessment.Repositório ComumTemmink, SJPeeters, KCBahadoer, RKranenbarg, MKRoodvoets, AGMelenhorst, JBurger, JWWolthuis, ARenehan, AGFigueiredo, NLPares, OrMartling, APerez, ROBeets, GLvan de Velde, CJNilsson, PJAghili, MKeshvari, ANouritaromlou, MKAhlberg, MKordnejad, SAleinikov, ADulskas, AAsoğlu, OTokmak, HBarroca, RGCaiado, AFRosa, IABreukink, SOCoraglio, MFIseas, SCreaven, BWinter, DCZaborowski, ACunningham, CGregory, ECusters, PAGeubels, BMDeBrun, LD’Hoore, ADimofte, GFechner, KMatzel, KFernandez, LHerrando, AIVieira, PGaertner, WBMadoff, RDGerard, JPJacquinot, FSchiappa, RGollins, SGonzalez, MVaccaro, CAHabr-Gama, ASão Julião, GHolman, FAHompes, RLameris, WKetelaers, SHRutten, HJLeitner, KMazzarisi, CMalcomson, LO’Dwyer, STSaunders, MMaroli, AMitchell, PMurad-Regadas, SPairola, APedraza, SISanchez, LFPennings, AJSpinelli, ASun, MA2023-10-29T20:58:00Z20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.26/47631engBr J Surg . 2023 May 16;110(6):676-684.10.1093/bjs/znad051info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-10-31T04:45:21Zoai:comum.rcaap.pt:10400.26/47631Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:26:12.378382Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Watch and wait after neoadjuvant treatment in rectal cancer: comparison of outcomes in patients with and without a complete response at first reassessment in the International Watch & Wait Database (IWWD) |
title |
Watch and wait after neoadjuvant treatment in rectal cancer: comparison of outcomes in patients with and without a complete response at first reassessment in the International Watch & Wait Database (IWWD) |
spellingShingle |
Watch and wait after neoadjuvant treatment in rectal cancer: comparison of outcomes in patients with and without a complete response at first reassessment in the International Watch & Wait Database (IWWD) Temmink, SJ Neoplasias Colorrectais/tratamento Terapia Neoadjuvante Conduta Expectante Rectal Neoplasms/therapy Rectal Neoplasms/therapy Watchful Waiting |
title_short |
Watch and wait after neoadjuvant treatment in rectal cancer: comparison of outcomes in patients with and without a complete response at first reassessment in the International Watch & Wait Database (IWWD) |
title_full |
Watch and wait after neoadjuvant treatment in rectal cancer: comparison of outcomes in patients with and without a complete response at first reassessment in the International Watch & Wait Database (IWWD) |
title_fullStr |
Watch and wait after neoadjuvant treatment in rectal cancer: comparison of outcomes in patients with and without a complete response at first reassessment in the International Watch & Wait Database (IWWD) |
title_full_unstemmed |
Watch and wait after neoadjuvant treatment in rectal cancer: comparison of outcomes in patients with and without a complete response at first reassessment in the International Watch & Wait Database (IWWD) |
title_sort |
Watch and wait after neoadjuvant treatment in rectal cancer: comparison of outcomes in patients with and without a complete response at first reassessment in the International Watch & Wait Database (IWWD) |
author |
Temmink, SJ |
author_facet |
Temmink, SJ Peeters, KC Bahadoer, R Kranenbarg, MK Roodvoets, AG Melenhorst, J Burger, JW Wolthuis, A Renehan, AG Figueiredo, NL Pares, Or Martling, A Perez, RO Beets, GL van de Velde, CJ Nilsson, PJ Aghili, M Keshvari, A Nouritaromlou, MK Ahlberg, M Kordnejad, S Aleinikov, A Dulskas, A Asoğlu, O Tokmak, H Barroca, RG Caiado, AF Rosa, IA Breukink, SO Coraglio, MF Iseas, S Creaven, B Winter, DC Zaborowski, A Cunningham, C Gregory, E Custers, PA Geubels, BM DeBrun, L D’Hoore, A Dimofte, G Fechner, K Matzel, K Fernandez, L Herrando, AI Vieira, P Gaertner, WB Madoff, RD Gerard, JP Jacquinot, F Schiappa, R Gollins, S Gonzalez, M Vaccaro, CA Habr-Gama, A São Julião, G Holman, FA Hompes, R Lameris, W Ketelaers, SH Rutten, HJ Leitner, K Mazzarisi, C Malcomson, L O’Dwyer, ST Saunders, M Maroli, A Mitchell, P Murad-Regadas, S Pairola, A Pedraza, SI Sanchez, LF Pennings, AJ Spinelli, A Sun, MA |
author_role |
author |
author2 |
Peeters, KC Bahadoer, R Kranenbarg, MK Roodvoets, AG Melenhorst, J Burger, JW Wolthuis, A Renehan, AG Figueiredo, NL Pares, Or Martling, A Perez, RO Beets, GL van de Velde, CJ Nilsson, PJ Aghili, M Keshvari, A Nouritaromlou, MK Ahlberg, M Kordnejad, S Aleinikov, A Dulskas, A Asoğlu, O Tokmak, H Barroca, RG Caiado, AF Rosa, IA Breukink, SO Coraglio, MF Iseas, S Creaven, B Winter, DC Zaborowski, A Cunningham, C Gregory, E Custers, PA Geubels, BM DeBrun, L D’Hoore, A Dimofte, G Fechner, K Matzel, K Fernandez, L Herrando, AI Vieira, P Gaertner, WB Madoff, RD Gerard, JP Jacquinot, F Schiappa, R Gollins, S Gonzalez, M Vaccaro, CA Habr-Gama, A São Julião, G Holman, FA Hompes, R Lameris, W Ketelaers, SH Rutten, HJ Leitner, K Mazzarisi, C Malcomson, L O’Dwyer, ST Saunders, M Maroli, A Mitchell, P Murad-Regadas, S Pairola, A Pedraza, SI Sanchez, LF Pennings, AJ Spinelli, A Sun, MA |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Comum |
dc.contributor.author.fl_str_mv |
Temmink, SJ Peeters, KC Bahadoer, R Kranenbarg, MK Roodvoets, AG Melenhorst, J Burger, JW Wolthuis, A Renehan, AG Figueiredo, NL Pares, Or Martling, A Perez, RO Beets, GL van de Velde, CJ Nilsson, PJ Aghili, M Keshvari, A Nouritaromlou, MK Ahlberg, M Kordnejad, S Aleinikov, A Dulskas, A Asoğlu, O Tokmak, H Barroca, RG Caiado, AF Rosa, IA Breukink, SO Coraglio, MF Iseas, S Creaven, B Winter, DC Zaborowski, A Cunningham, C Gregory, E Custers, PA Geubels, BM DeBrun, L D’Hoore, A Dimofte, G Fechner, K Matzel, K Fernandez, L Herrando, AI Vieira, P Gaertner, WB Madoff, RD Gerard, JP Jacquinot, F Schiappa, R Gollins, S Gonzalez, M Vaccaro, CA Habr-Gama, A São Julião, G Holman, FA Hompes, R Lameris, W Ketelaers, SH Rutten, HJ Leitner, K Mazzarisi, C Malcomson, L O’Dwyer, ST Saunders, M Maroli, A Mitchell, P Murad-Regadas, S Pairola, A Pedraza, SI Sanchez, LF Pennings, AJ Spinelli, A Sun, MA |
dc.subject.por.fl_str_mv |
Neoplasias Colorrectais/tratamento Terapia Neoadjuvante Conduta Expectante Rectal Neoplasms/therapy Rectal Neoplasms/therapy Watchful Waiting |
topic |
Neoplasias Colorrectais/tratamento Terapia Neoadjuvante Conduta Expectante Rectal Neoplasms/therapy Rectal Neoplasms/therapy Watchful Waiting |
description |
Background: In rectal cancer, watch and wait for patients with a cCR after neoadjuvant treatment has an established evidence base. However, there is a lack of consensus on the definition and management of a near-cCR. This study aimed to compare outcomes in patients who achieved a cCR at first reassessment versus later reassessment. Methods: This registry study included patients from the International Watch & Wait Database. Patients were categorized as having a cCR at first reassessment or at later reassessment (that is near-cCR at first reassessment) based on MRI and endoscopy. Organ preservation, distant metastasis-free survival, and overall survival rates were calculated. Subgroup analyses were done for near-cCR groups based on the response evaluation according to modality. Results: A total of 1010 patients were identified. At first reassessment, 608 patients had a cCR; 402 had a cCR at later reassessment. Median follow-up was 2.6 years for patients with a cCR at first reassessment and 2.9 years for those with a cCR at later reassessment. The 2-year organ preservation rate was 77.8 (95 per cent c.i. 74.2 to 81.5) and 79.3 (75.1 to 83.7) per cent respectively (P = 0.499). Similarly, no differences were found between groups in distant metastasis-free survival or overall survival rate. Subgroup analyses showed a higher organ preservation rate in the group with a near-cCR categorized exclusively by MRI. Conclusion: Oncological outcomes for patients with a cCR at later reassessment are no worse than those of patients with a cCR at first reassessment. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-10-29T20:58:00Z 2023 2023-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.26/47631 |
url |
http://hdl.handle.net/10400.26/47631 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Br J Surg . 2023 May 16;110(6):676-684. 10.1093/bjs/znad051 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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application/pdf |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799134143735398400 |