Mejor calidad de vida y menor incontinencia fecal en pacientes con cáncer de recto con la estrategia de seguimiento watch and wait

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.rgmx.2020.06.006

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…The assessment of QoL in terms of bowel, sexual, rectal continence and quality of life in general was recorded through the administration of questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) models Quality of life-Core (QLQ-C) 30, QLQ Colorectal Cancer Module-29, Fecal Incontinence Quality of Life (FIQL) scale [32,33]. Answers to questions relating the same broad category (intestinal function, sexual function, habits, and relational aspect) were aggregated, analysed, and presented together.…”

Section: Clinical Workflowmentioning

confidence: 99%

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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Section: Clinical Workflowmentioning

confidence: 99%

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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“…Several studies have shown that NOM leads to a higher health-related QoL compared to TME surgery [12,13]. Little is known about the quality of life of those patients who, after an initial W&W approach, eventually require TME surgery.…”

Section: Introductionmentioning

confidence: 99%

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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Mejor calidad de vida y menor incontinencia fecal en pacientes con cáncer de recto con la estrategia de seguimiento watch and wait

Cited by 2 publications

References 23 publications

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

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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