2017
DOI: 10.1245/s10434-017-5841-3
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Nonoperative Management or ‘Watch and Wait’ for Rectal Cancer with Complete Clinical Response After Neoadjuvant Chemoradiotherapy: A Critical Appraisal

Abstract: Purpose There is increasing interest in non-operative management (NOM) for rectal cancer with complete clinical (cCR) response after neoadjuvant chemoradiation (nCRT). The aim of this review is to summarize the available data on NOM, with the intention of formulating standardised protocols on which to base future investigation. Methods Systematic review following PRISMA guidelines was conducted. A highly sensitive literature search identified all relevant studies published between Jan 2004 and Dec 2016. Data… Show more

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Cited by 73 publications
(68 citation statements)
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“…However, in recent years there has been debate over which approach provides best TME and oncological resection. 49 To date, roTME, taTME, and lapTME have yielded comparable pathological and oncological outcomes, and this is supported by the finding in this review. Though results seem promising, it should be acknowledged that there is likely a selection bias, and the institutional reporting these studies typically have extensive experience in the techniques.…”
Section: -Day Mortalitysupporting
confidence: 78%
See 1 more Smart Citation
“…However, in recent years there has been debate over which approach provides best TME and oncological resection. 49 To date, roTME, taTME, and lapTME have yielded comparable pathological and oncological outcomes, and this is supported by the finding in this review. Though results seem promising, it should be acknowledged that there is likely a selection bias, and the institutional reporting these studies typically have extensive experience in the techniques.…”
Section: -Day Mortalitysupporting
confidence: 78%
“…In addition, surgeons have adopted more minimal invasive surgical approaches to benefit recovery, without compromising oncological results. However, in recent years there has been debate over which approach provides best TME and oncological resection …”
Section: Discussionmentioning
confidence: 99%
“…There is still a wide variation in the exact definition of a cCR. A combination of digital rectal examination, endoscopy, CEA measurement, CT and MRI seems to be most accurate in evaluating any response . The exact criteria for cCR were not assessed in the guidelines examined in this study.…”
Section: Discussionmentioning
confidence: 93%
“…The primary goal of neoadjuvant radiotherapy was to reduce tumor volume and increase the number of surgical procedures that save the anal sphincter. There are currently no clear criteria to guide a patient towards a w&w strategy (18). Most studies published in the literature are of poor quality, retrospective with heterogeneous populations in terms of age, tumor staging and comorbidities.…”
Section: Discussionmentioning
confidence: 99%