Recurrence Risk Low After One Year of Watch-and-Wait for Rectal Cancer

FRIDAY, Dec. 18, 2020 (HealthDay News) — After sustaining a clinical complete response for one year with a watch-and-wait strategy following a complete response to rectal cancer treatment, risks for local regrowth and distant metastases during the subsequent two years are low, according to a study published online Dec. 11 in The Lancet Oncology.

Laura M. Fernandez, M.D., from the Champalimaud Foundation in Lisbon, Portugal, and colleagues conducted conditional survival modeling using the International Watch & Wait Database (47 clinics across 15 countries). The analysis included 793 adults with rectal cancer who had a clinical complete response after neoadjuvant chemotherapy and who were subsequently managed by a watch-and-wait strategy between Nov. 25, 1991, and Dec. 31, 2015.

The researchers found that during a median follow-up of 55.2 months, the probability of remaining free from local regrowth for an additional two years was 88.1, 97.3, and 98.6 percent if a patient sustained a clinical complete response for one, three, and five years, respectively. Among patients who had a clinical complete response without distant metastases for one year, the probability of remaining free from distant metastases for a further two years was 93.8 percent; this probability increased to 97.8 and 96.6 percent for patients with a clinical complete response without distant metastases for three and five years, respectively.

“These results suggest that the intensity of active surveillance in patients with rectal cancer managed by a watch-and-wait approach could be reduced if they achieve and maintain a clinical complete response within the first three years of starting this approach,” the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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