Belkovsky Mikhael, Alipouriani Ali, Kanters Arielle E, Sommovilla Joshua, Gorgun Emre, Liska David, Steele Scott R
Department of Surgery, University of Massachusetts, Worcester, Massachusetts.
Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
Clin Colon Rectal Surg. 2024 Nov 4;38(4):290-300. doi: 10.1055/s-0044-1791722. eCollection 2025 Jul.
The nonoperative management of rectal cancer, known as watch and wait (W&W), has gained increasing acceptance in recent years. This approach is based on using complete clinical response (cCR) as a marker for complete pathological response (pCR) following neoadjuvant chemoradiation (nCRT). Advances in nCRT regimens have resulted in higher tumor regression rates, making W&W a viable option for selected patients. This study presents the historical evolution and efficacy of the W&W strategy and offers modern recommendations based on recent clinical findings. Key findings include an 85 to 92% 5-year disease-free survival rate in patients achieving cCR, highlighting the potential for improved quality of life and reduced morbidity without compromising survival outcomes.
直肠癌的非手术治疗，即观察等待（W&W），近年来越来越被广泛接受。这种方法基于将完全临床缓解（cCR）作为新辅助放化疗（nCRT）后完全病理缓解（pCR）的标志。nCRT方案的进展导致了更高的肿瘤退缩率，使W&W成为部分患者的可行选择。本研究介绍了W&W策略的历史演变和疗效，并根据近期临床发现提供了现代建议。主要发现包括达到cCR的患者5年无病生存率为85%至92%，突出了在不影响生存结果的情况下改善生活质量和降低发病率的潜力。
