# Low rectal cancer treatment strategies: a cohort study assessing watch and wait.

**Tumor:** Cáncer rectal
**Autores:** Pinto JC, Pereira AD, Pimenta A et al
**Revista:** J Cancer Res Clin Oncol (2020)
**PMID:** 32435893 | **PMCID:** PMC11804403
**DOI:** [10.1007/s00432-020-03248-0](https://doi.org/10.1007/s00432-020-03248-0)
**Fuente:** PubMed Central (open access)

## Relevancia
Tumor rectal post-quimiorradioterapia neoadyuvante: aporta evidencia sobre la conversión cN+ → ypN0 en el mesorrecto, valor pronóstico de la respuesta ganglionar y selección de pacientes para watch-and-wait u organ preservation. Paralelo al carcinoma de mama: la respuesta ganglionar tras NAC es un marcador pronóstico independiente y modula la cirugía locorregional.

## Abstract
Treatment strategies for low rectal cancer have been evolving toward achieving less treatment morbidity with the same oncological success-we aimed to assess the results of the new watch and wait (W&W) strategy in our cohort.

A tertiary care cohort study was conducted. New patients with rectal adenocarcinoma up to 6 cm from the anal margin, cM0, locally staged higher than cT1N0, evaluated between November 2014 and October 2018, were included. All 93 patients received neoadjuvant radiotherapy &#xb1; chemotherapy. Re-evaluation was planned 8-12 weeks after the end of treatment. Patients showing clinical complete response (cCR) were given the choice of either to proceed to surgery or to enter W&W.

Of the 93 patients, 82.8% were re-evaluated and 20.8% had cCR. Patients in clinical stages II/III were significantly less likely to achieve cCR than those in stage I (p&#xa0;=&#xa0;0.017). After a mean follow-up of 17.44 months, there were 4 regrowths in the 16 patients under W&W, all submitted to R0 surgery, ypN0; there were no deaths or local recurrences; one patient with regrowth had distant recurrence. Sixty patients underwent direct surgery after a mean follow-up of 16.23 months; 3 patients had local and distant recurrences; 7 others had only distant recurrences; there were 8 deaths. There were no statistically significant differences between patients under W&W and patients who underwent direct surgery regarding local or distant recurrences, or death (p&#x2009;>&#x2009;0.9; p&#x2009;=&#x2009; 0.44; p&#x2009;=&#x2009; 0.19, respectively).

The W&W strategy for low rectal cancer achieved the same oncological outcomes as the traditional strategy while sparing some patients from surgery.

## Acceso
Disponible en PMC: https://pmc.ncbi.nlm.nih.gov/articles/PMC11804403/

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*Datos de PubMed. Citar: doi 10.1007/s00432-020-03248-0*
