Better quality of life and reduced fecal incontinence in rectal cancer patients with the watch-and-wait follow-up strategy

Pascual-Russo, Agostina; Milito, D; Facio, Lucila; Furia, Marina; Forestier, V; Iseas, Soledad; Méndez, Guillermo; Coraglio, Mariana; Lumi, Carlos Miguel; Masciangioli, Guillermo; Mauriño, Eduardo; Vázquez, Horacio

doi:10.1016/j.rgmxen.2020.07.009

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…The study concluded that the optimal follow-up schedule for a WW policy in patients with cCR after chemoradiation for rectal cancer should include frequent endoscopy and to a lesser degree MRI in the first 2 years. Hence, the intensity of active surveillance in patients with rectal cancer managed by a WW approach could be reduced if they achieve and maintain a cCR within the first three years of starting this approach 4,6,7 .…”

Section: Discussionmentioning

confidence: 99%

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"Watch and Wait Policy – A Pathway to a Better Quality of Life for Patients With Rectal Cancer: A Review"

BLAJIN¹,

TANASE²,

POPA³

et al. 2022

Arch Balk Med Union

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Section: Discussionmentioning

confidence: 99%

“…Quality of life: significant difference between the two groups (G1: 3.7 vs. G2: 2.8; p < 0.03). The study concluded that the WW follow-up strategy in patients with locally advanced rectal cancer was associated with better quality of life and reduced faecal incontinence 4 .…”

Section: Retrospective 304mentioning

confidence: 98%

"Watch and Wait Policy – A Pathway to a Better Quality of Life for Patients With Rectal Cancer: A Review"

BLAJIN¹,

TANASE²,

POPA³

et al. 2022

Arch Balk Med Union

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Could the conservative approach be considered safe in the treatment of locally advanced rectal cancer in case of a clinical near-complete or complete response? A retrospective analysis

Chiloiro

Meldolesi

Giraffa

et al. 2021

Clinical and Translational Radiation Oncology

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Background: Conservative approach has emerged as an option for the management of rectal cancer (RC) patients with a near or complete clinical response after neoadjuvant chemoradiotherapy (nCRT). The aim of this study is to assess the impact of the conservative approach by comparing patients' survival outcomes and quality of life with those who had surgical resection. Methods: A single-institution and retrospective study including RC patients who reached a near complete or complete clinical response after nCRT from January 2010 to September 2019. Conservative approaches included local excision or watch and wait strategy; surgery approaches included anterior resection or abdominal-perineal resection. Local regrowth (LR), overall survival, disease free survival, metastasis free survival and colostomy free survival were evaluated through Kaplan-Meier curves and compared trough log-rank tests. Quality of life was measured by the following validated questionnaires: EORTC QLC30, EORTC QLQ-CR29 and Fecal Incontinence Quality of Life scale. Results: Overall 157 patients were analyzed: 105 (66,9%) underwent radical surgery and 52 (33,1%) had a conservative approach. With a median follow-up of 51 months, 2 patients in the surgical group had a local recurrence and 8 in the conservative group had a LR, respectively. Distance metastasis occurred in 7 and 1 patients of surgical and conservative group, respectively. No differences were detected in terms of survival outcomes except for colostomy free survival (p: 0,01). The conservative group showed better intestinal (p < 0.01) and sexual (p: 0,04) function and emotional status (p: 0,02). Conclusions: Conservative approach seems to be safe in terms of survival outcomes with a significant advantage on quality of life in RC patients who achieved clinical complete response after nCRT.

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Delayed Surgery after Neoadjuvant Treatment for Rectal Cancer Does Not Lead to Impaired Quality of Life, Worry for Cancer, or Regret

Meyer

Meuzelaar

Schoenaker

et al. 2021

Cancers

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Non operative management of complete clinical responders after neoadjuvant treatment for rectal cancer enjoys an increasing popularity because of the increased functional outcome results. Even a near complete response can evolve in a cCR, and therefore further delaying response assessment is accepted. However, up to 40% of patients will develop a regrowth and will eventually require delayed surgery. It is presently unknown if and to what extent quality of life of these patients is affected, compared to patients who undergo immediate surgery. Between January 2015-May 2020, 200 patients were treated with neoadjuvant therapy of whom 94 received TME surgery. Fifty-one (59%) of 87 alive patients returned the questionnaires: 33 patients who underwent immediate and 17 patients who underwent delayed surgery. Quality of life was measured through the QLQ-C30, QLQ-CR29, and Cancer Worry Scale questionnaires. Regret to participate in repeated response assessment protocol was assessed through the Decision Regret Scale. Exploratory factor analysis (EFA) and a ‘known groups comparison’ was performed to assess QLQ questionnaires validity in this sample. Higher mean physical function scores (89.2 vs. 77.6, p = 0.03) were observed in the immediate surgery group, which lost significance after correction for operation type (p = 0.25). Arousal for men was higher in the delayed surgery group (20.0 vs. 57.1, p = 0.02). There were no differences between surgical groups for the other questionnaire items. Worry for cancer was lower in the delayed surgery group (10.8 vs. 14.0, p = 0.21). Regret was very low (12–16%). EFA reproduced most QLQ C-30 and CR29 subscales with good internal consistency. Quality of life is not impaired in patients undergoing delayed TME surgery after neoadjuvant treatment for rectal cancer. Moreover, there is very low regret and no increase in worry for cancer. Therefore, from a quality of life perspective, this study supports a repeated response assessment strategy after CRTx for rectal carcinoma to identify all complete responders.

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Better quality of life and reduced fecal incontinence in rectal cancer patients with the watch-and-wait follow-up strategy

Cited by 3 publications

References 22 publications

"Watch and Wait Policy – A Pathway to a Better Quality of Life for Patients With Rectal Cancer: A Review"

"Watch and Wait Policy – A Pathway to a Better Quality of Life for Patients With Rectal Cancer: A Review"

Could the conservative approach be considered safe in the treatment of locally advanced rectal cancer in case of a clinical near-complete or complete response? A retrospective analysis

Delayed Surgery after Neoadjuvant Treatment for Rectal Cancer Does Not Lead to Impaired Quality of Life, Worry for Cancer, or Regret

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