Current Status of “Watch-and-Wait” Rectal Cancer Treatment in Asia-Pacific Countries

허정욱; Kotaro Maeda; Zheng Liu; Xishan Wang; April Camilla Roslani; 이우용

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자료유형: 학술저널

저자정보: 허정욱 (삼성서울병원) Kotaro Maeda (Fujita Health University Hospital) Zheng Liu (Peking Union Medical College) Xishan Wang (Peking Union Medical College) April Camilla Roslani (University of Malaya) 이우용 (삼성서울병원)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.36 No.2

발행연도: 2020.1

수록면: 70 - 77 (8page)

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Purpose: Current acceptance of the watch-and-wait (W&W) approach by surgeons in Asia-Pacific countries is unknown. An international survey was performed to determine status of the W&W approach on behalf of the Asia-Pacific Federation of Coloproctology (APFCP). Methods: Surgeons in the APFCP completed an Institutional Review Board-approved anonymous e-survey and/or printed letters (for China) containing 19 questions regarding nonsurgical close observation in patients who achieved clinical complete response (cCR) to neoadjuvant chemoradiotherapy (nCRT). Results: Of the 417 responses, 80.8% (n = 337) supported the W&W approach and 65.5% (n = 273) treated patients who achieved cCR after nCRT. Importantly, 78% of participants (n = 326) preferred a selective W&W approach in patients with old age and medical comorbidities who achieved cCR. In regard to restaging methods after nCRT, the majority of respondents based their decision to use W&W on a combination of magnetic resonance imaging results (94.5%, n = 394) with other test results. For interval between nCRT completion and tumor response assessment, most participants used 8 weeks (n = 154, 36.9%), followed by 6 weeks (n = 127, 30.5%) and 4 weeks (n = 102, 24.5%). In response to the question of how often responders followed-up after W&W, the predominant period was every 3 months (209 participants, 50.1%) followed by every 2 months (75 participants, 18.0%). If local regrowth was found during follow-up, most participants (79.9%, n = 333) recommended radical surgery as an initial management. Conclusion: The W&W approach is supported by 80% of Asia-Pacific surgeons and is practiced at 65%, although heterogeneous hospital or society protocols are also observed. These results inform oncologists of future clinical study participation.

#Rectal neoplasms #Neoadjuvant chemoradiotherapy #Watch and wait

참고문헌 (14)

참고문헌 신청

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van Gijn W / 2011 / Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial / Lancet Oncol 12:575~582

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Dossa F / 2017 / A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation : a systematic review and meta-analysis / Lancet Gastroenterol Hepatol 2:501~513

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