Long-term outcomes in a retrospective cohort of patients with rectal cancer with complete response after total neoadjuvant therapy: a propensity-score weighted analysis
Background: The watch-and-wait (W&W) strategy is a novel treatment option for patients with rectal cancer who have a strong desire for organ preservation. The study aimed to explore the long-term outcomes of the W&W strategy in a large cohort of rectal cancer patients who achieved a clinical...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-09-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/17588359231197955 |
| _version_ | 1797689375786532864 |
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| author | Jingwen Wang Lijie Zhang Minghe Wang Jing Zhang Yaqi Wang Juefeng Wan Guichao Li Hui Zhang Yan Wang Ruiyan Wu Zhiyuan Zhang Xinxiang Li Ye Xu Ji Zhu Lijun Shen Fan Xia Zhen Zhang |
| author_facet | Jingwen Wang Lijie Zhang Minghe Wang Jing Zhang Yaqi Wang Juefeng Wan Guichao Li Hui Zhang Yan Wang Ruiyan Wu Zhiyuan Zhang Xinxiang Li Ye Xu Ji Zhu Lijun Shen Fan Xia Zhen Zhang |
| author_sort | Jingwen Wang |
| collection | DOAJ |
| description | Background: The watch-and-wait (W&W) strategy is a novel treatment option for patients with rectal cancer who have a strong desire for organ preservation. The study aimed to explore the long-term outcomes of the W&W strategy in a large cohort of rectal cancer patients who achieved a clinical complete response (cCR) after consolidation total neoadjuvant therapy (TNT), and to compare with patients who achieved a pathological complete response (pCR) after radical surgery. Methods: The W&W group comprised patients who were assessed as having a cCR after consolidation TNT and adopted the W&W strategy. Patients who underwent standard resection and achieved a pCR were compared as a reference. Inverse probability of treatment weighting (IPTW)-adjusted Kaplan–Meier analysis with log-rank test was used to compare survival outcomes. Results: We included 89 and 171 patients in the W&W and pCR groups, respectively. The median follow-up period was 45 and 58 months for the W&W and pCR groups, respectively. After IPTW adjustment, the 2-year local regrowth/recurrence rate for the W&W and pCR groups were 9.9% and 2.0%, respectively ( p < 0.001). The W&W and pCR groups had similar 5-year outcomes, including overall survival, disease-free survival, and distant metastasis-free survival (all p > 0.05). No significant difference was observed in the rates of distant metastasis between patients in the W&W group with local regrowth and those without local regrowth (25% versus 6.2%, p = 0.119). Conclusion: Patients who were managed with a W&W strategy after consolidation TNT had favorable survival outcomes, which were similar to those of patients with a pCR. The rate of local regrowth in W&W patients was lower in our study than in other studies as a result of the implementation of consolidation TNT. |
| first_indexed | 2024-03-12T01:44:46Z |
| format | Article |
| id | doaj.art-cb780a48f7ec4f92a0a5ac42df6357b8 |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-03-12T01:44:46Z |
| publishDate | 2023-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-cb780a48f7ec4f92a0a5ac42df6357b82023-09-09T16:33:30ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592023-09-011510.1177/17588359231197955Long-term outcomes in a retrospective cohort of patients with rectal cancer with complete response after total neoadjuvant therapy: a propensity-score weighted analysisJingwen WangLijie ZhangMinghe WangJing ZhangYaqi WangJuefeng WanGuichao LiHui ZhangYan WangRuiyan WuZhiyuan ZhangXinxiang LiYe XuJi ZhuLijun ShenFan XiaZhen ZhangBackground: The watch-and-wait (W&W) strategy is a novel treatment option for patients with rectal cancer who have a strong desire for organ preservation. The study aimed to explore the long-term outcomes of the W&W strategy in a large cohort of rectal cancer patients who achieved a clinical complete response (cCR) after consolidation total neoadjuvant therapy (TNT), and to compare with patients who achieved a pathological complete response (pCR) after radical surgery. Methods: The W&W group comprised patients who were assessed as having a cCR after consolidation TNT and adopted the W&W strategy. Patients who underwent standard resection and achieved a pCR were compared as a reference. Inverse probability of treatment weighting (IPTW)-adjusted Kaplan–Meier analysis with log-rank test was used to compare survival outcomes. Results: We included 89 and 171 patients in the W&W and pCR groups, respectively. The median follow-up period was 45 and 58 months for the W&W and pCR groups, respectively. After IPTW adjustment, the 2-year local regrowth/recurrence rate for the W&W and pCR groups were 9.9% and 2.0%, respectively ( p < 0.001). The W&W and pCR groups had similar 5-year outcomes, including overall survival, disease-free survival, and distant metastasis-free survival (all p > 0.05). No significant difference was observed in the rates of distant metastasis between patients in the W&W group with local regrowth and those without local regrowth (25% versus 6.2%, p = 0.119). Conclusion: Patients who were managed with a W&W strategy after consolidation TNT had favorable survival outcomes, which were similar to those of patients with a pCR. The rate of local regrowth in W&W patients was lower in our study than in other studies as a result of the implementation of consolidation TNT.https://doi.org/10.1177/17588359231197955 |
| spellingShingle | Jingwen Wang Lijie Zhang Minghe Wang Jing Zhang Yaqi Wang Juefeng Wan Guichao Li Hui Zhang Yan Wang Ruiyan Wu Zhiyuan Zhang Xinxiang Li Ye Xu Ji Zhu Lijun Shen Fan Xia Zhen Zhang Long-term outcomes in a retrospective cohort of patients with rectal cancer with complete response after total neoadjuvant therapy: a propensity-score weighted analysis Therapeutic Advances in Medical Oncology |
| title | Long-term outcomes in a retrospective cohort of patients with rectal cancer with complete response after total neoadjuvant therapy: a propensity-score weighted analysis |
| title_full | Long-term outcomes in a retrospective cohort of patients with rectal cancer with complete response after total neoadjuvant therapy: a propensity-score weighted analysis |
| title_fullStr | Long-term outcomes in a retrospective cohort of patients with rectal cancer with complete response after total neoadjuvant therapy: a propensity-score weighted analysis |
| title_full_unstemmed | Long-term outcomes in a retrospective cohort of patients with rectal cancer with complete response after total neoadjuvant therapy: a propensity-score weighted analysis |
| title_short | Long-term outcomes in a retrospective cohort of patients with rectal cancer with complete response after total neoadjuvant therapy: a propensity-score weighted analysis |
| title_sort | long term outcomes in a retrospective cohort of patients with rectal cancer with complete response after total neoadjuvant therapy a propensity score weighted analysis |
| url | https://doi.org/10.1177/17588359231197955 |
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