Long-Term Follow-Up Supports Watch and Wait in Rectal Cancer

Chemoradiotherapy, total mesorectal excision, and adjuvant chemotherapy are standard treatments for locally advanced rectal cancer. There is increasing interest in providing all therapy before surgery — total neoadjuvant therapy — and in the potential for organ preservation and deferral of surgery in patients achieving clinical complete response to treatment.

Using the International Watch and Wait Database, investigators evaluated outcomes in 793 patients with rectal cancer who were observed without surgery after achieving a clinical complete response to chemoradiotherapy from 1991 to 2015. Prior to treatment most patients had clinical T3 (63%) or T2 (32%) status, 57% were node positive, 60% had clinical stage III disease, and 60% received ≥…