COMPLETE CLINICAL RESPONSE OF RECTAL CANCER TO CHEMORADIOTHERAPY: TACTICS

Abstract

We analyzed literature data and our results of preoperative radiotherapy for 179 patients with resectable rectal cancer T2-4N0-2M0. The purpose of the study was to analyze the complete clinical response to chemoradiotherapy for rectal cancer. The results showed the advantages of monitoring patients with complete clinical response before total mesorectumectomy: no complications and deaths after surgery; absence of a syndrome of low anterior resection of the rectum and dysfunction of the pelvic organs; low intestinal stoma rates; similar overall survival of patients. The problems associated with the “Watch and Wait” tactics were: absence of standardized criteria for including patients in the protocol and absence of the standard protocol of treatment; no reliable criteria for the complete clinical response; high recurrence rates. Thus the “Watch and Wait” approach could be applied during a clinical study at a reference center with a multidisciplinary medical team; otherwise, total mesorectumectomy should be used as the standard treatment for rectal cancer.