Li Z W
Department of Pathology, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Mar 25;23(3):248-251. doi: 10.3760/cma.j.cn.441530-20200224-00079.
Some studies have demonstrated promising results of watch and wait (W&W) approaches in carefully selected patients with locally advanced rectal cancer who get a clinical complete response (cCR) after neoadjuvant chemoradiotherapy (nCRT). This approach of organ- preservation helps patients avoid surgery and its related morbidity and mortality. nCRT will lead to the regression of the tumor cells and the uneven distribution of the residual tumor cells. The reliability of biopsy is still unsatisfactory in W&W strategy due to the high ratio of false negative cases. Therefore, the patients with negative histopathological assessment should also receive a strict follow-up. In the future, immune microenvironment and molecular markers, patient derived organoid, circulating tumor cells (CTCs) and circulating cell-free nucleic acids (cfDNA) may be helpful for screening and monitoring patients undergoing W&W.
一些研究表明，对于经新辅助放化疗（nCRT）后获得临床完全缓解（cCR）的精心挑选的局部晚期直肠癌患者，观察等待（W&W）方法取得了令人鼓舞的结果。这种器官保留方法有助于患者避免手术及其相关的发病率和死亡率。nCRT会导致肿瘤细胞消退以及残留肿瘤细胞分布不均。在W&W策略中，由于假阴性病例比例较高，活检的可靠性仍不尽人意。因此，组织病理学评估为阴性的患者也应接受严格随访。未来，免疫微环境和分子标志物、患者来源的类器官、循环肿瘤细胞（CTC）和循环游离核酸（cfDNA）可能有助于筛选和监测接受W&W的患者。
