Short-term outcomes from the 'Watch and Wait' (WoW) study: prospective cohort study.

IF 3.5 3区 医学 Q1 SURGERY
BJS Open Pub Date : 2024-12-30 DOI:10.1093/bjsopen/zrae151
Daniel Rydbeck, Najia Azhar, Lennart Blomqvist, Abbas Chabok, Joakim Folkesson, Anders Gerdin, Linda Hermus, Peter Matthiessen, Anna Martling, Per J Nilsson, Eva Angenete
{"title":"Short-term outcomes from the 'Watch and Wait' (WoW) study: prospective cohort study.","authors":"Daniel Rydbeck, Najia Azhar, Lennart Blomqvist, Abbas Chabok, Joakim Folkesson, Anders Gerdin, Linda Hermus, Peter Matthiessen, Anna Martling, Per J Nilsson, Eva Angenete","doi":"10.1093/bjsopen/zrae151","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Despite absence of level 1 evidence on the long-term oncological safety of non-operative management for rectal cancer (watch and wait), increased implementation has occurred globally over the past decades. In Sweden, a pan-national prospective non-randomized study was initiated in 2017 to assess its implementation.</p><p><strong>Method: </strong>Patients with biopsy-proven rectal cancer receiving neoadjuvant therapy according to national guidelines in whom a clinical complete response was detected at reassessment were eligible for inclusion following informed consent. Only patients with an opportunistic watch-and-wait approach were included. Inclusion and follow-up, according to the study protocol, was managed at the participating study centres. The primary outcome measure of the study is 3-year disease-free survival. Here, the secondary short-term outcomes local regrowth rate, distant metastasis rate and outcomes after surgery for regrowth, at 6 months follow-up, are reported.</p><p><strong>Results: </strong>Between January 2017 and February 2023, 211 patients with a clinical complete response were included in the study. Thirty-three (16%) patients developed suspicious regrowth within 6 months of inclusion. Thirty-two of 33 patients had abdominal resectional surgery for regrowth. The curative intention rate was 94% for patients with regrowth. Three patients (1.4%) developed distant metastases within 6 months of inclusion.</p><p><strong>Conclusion: </strong>This Swedish national study on watch and wait reports regrowth rates after 6 months are in line with previous reports in the literature. Nearly all patients with early regrowth could be treated with salvage surgery and curative intent.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"9 1","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758366/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJS Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/bjsopen/zrae151","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Despite absence of level 1 evidence on the long-term oncological safety of non-operative management for rectal cancer (watch and wait), increased implementation has occurred globally over the past decades. In Sweden, a pan-national prospective non-randomized study was initiated in 2017 to assess its implementation.

Method: Patients with biopsy-proven rectal cancer receiving neoadjuvant therapy according to national guidelines in whom a clinical complete response was detected at reassessment were eligible for inclusion following informed consent. Only patients with an opportunistic watch-and-wait approach were included. Inclusion and follow-up, according to the study protocol, was managed at the participating study centres. The primary outcome measure of the study is 3-year disease-free survival. Here, the secondary short-term outcomes local regrowth rate, distant metastasis rate and outcomes after surgery for regrowth, at 6 months follow-up, are reported.

Results: Between January 2017 and February 2023, 211 patients with a clinical complete response were included in the study. Thirty-three (16%) patients developed suspicious regrowth within 6 months of inclusion. Thirty-two of 33 patients had abdominal resectional surgery for regrowth. The curative intention rate was 94% for patients with regrowth. Three patients (1.4%) developed distant metastases within 6 months of inclusion.

Conclusion: This Swedish national study on watch and wait reports regrowth rates after 6 months are in line with previous reports in the literature. Nearly all patients with early regrowth could be treated with salvage surgery and curative intent.

观察和等待(WoW)研究的短期结果:前瞻性队列研究。
背景:尽管缺乏关于直肠癌非手术治疗长期肿瘤安全性的一级证据(观察和等待),但在过去几十年中,全球范围内实施的非手术治疗越来越多。在瑞典,2017年启动了一项泛国家前瞻性非随机研究来评估其实施情况。方法:根据国家指南接受活检证实的直肠癌新辅助治疗的患者,在重新评估时检测到临床完全缓解,符合知情同意纳入。只有采取机会主义观察和等待方法的患者被纳入研究。根据研究方案,纳入和随访是在参与研究中心进行的。该研究的主要结局指标是3年无病生存期。本文报道了随访6个月后的次要短期预后,局部再生率、远处转移率和手术后再生结果。结果:在2017年1月至2023年2月期间,211名临床完全缓解的患者被纳入研究。33例(16%)患者在6个月内出现可疑的再生。33例患者中有32例进行了腹部切除手术。再生患者的治愈意向率为94%。3名患者(1.4%)在6个月内发生远处转移。结论:这项关于观察和等待的瑞典国家研究报告了6个月后的再生长率,与文献中先前的报告一致。几乎所有早期再生的患者都可以通过挽救性手术和治疗目的来治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
BJS Open
BJS Open SURGERY-
CiteScore
6.00
自引率
3.20%
发文量
144
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信