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• W2160246732 abstract "After neoadjuvant treatment in locally advanced rectal cancer, and based on the current evidence, patients undergo surgery, which includes total mesorectal excision [1.Cellini F. Valentini V. Current perspectives on preoperative integrated treatments for locally advanced rectal cancer: a review of agreement and controversies.Oncology (Williston Park). 2012; 26 (741): 730-735PubMed Google Scholar], sometimes with a definitive ostomy, regardless of achieving a clinical complete response (cCR), due to the lack of correlation between clinical and pathological responses [2.Hiotis S.P. Weber S.M. Cohen A.M. Assessing the predictive value of clinical complete response to neoadjuvant therapy for rectal cancer: an analysis of 488 patients.J Am Coll Surg. 2002; 194 (discussion 135–136): 131-135doi:10.1016/S1072-7515(01)01159-0Abstract Full Text Full Text PDF PubMed Scopus (314) Google Scholar]. A recent publication has raised a debate whether in some cases patients who get a cCR could go into a wait-and-see policy in order to avoid a mutilating surgery [3.Maas M. Beets-Tan R.G. Lambregts D.M. et al.Wait-and-see policy for clinical complete responders after chemoradiation for rectal cancer.J Clin Oncol. 2011; 29: 4633-4640doi:10.1200/JCO.2011.37.7176Crossref PubMed Scopus (775) Google Scholar], although it is true that the criteria of cCR, with or without the excision of the residual scar, has not been validated yet. The recent publication in this journal of the ESMO Consensus Guidelines for Management of Patients with Colon and Rectal Cancer [4.Schmoll H.J. Van Cutsem E. Stein A. et al.ESMO Consensus Guidelines for management of patients with colon and rectal cancer. A personalized approach to clinical decision making.Ann Oncol. 2012; 23: 2479-2516doi:10.1093/annonc/mds236Abstract Full Text Full Text PDF PubMed Scopus (1116) Google Scholar] offers, beyond the standard approach, the possibility of a conservative management in selected patients in this scenario (e.g. young patients who need a definitive ostomy), including the recommendation of the use of a nomogram to establish the risk of locoregional relapse [5.Valentini V. van Stiphout R.G. Lammering G. et al.Nomograms for predicting local recurrence, distant metastases, and overall survival for patients with locally advanced rectal cancer on the basis of European randomized clinical trials.J Clin Oncol. 2011; 29: 3163-3172doi:10.1200/JCO.2010.33.1595Crossref PubMed Scopus (379) Google Scholar]. Until now, current nomograms for predicting the risk of local recurrence after achieving a cCR include pathological response of the primary tumor and node involvement, data that could not be known without going for a surgery. This is why we do not have information a priori of the risk of relapse in our patients. However, in our opinion, the wait-and-see approach in selected patients with rectal cancer who have achieved a cCR after neoadjuvant treatment might be offered taking into account present data and after a discussion on risk benefits with the patient. The authors have declared no conflicts of interest." @default.
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• W2160246732 date "2013-03-01" @default.
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• W2160246732 title "Clinical complete response in locally advanced rectal cancer: can we offer a wait-and-see policy?" @default.
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• W2160246732 doi "https://doi.org/10.1093/annonc/mds651" @default.
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