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The Watch and Wait Approach After Neoadjuvant Therapy: The Australian Viewpoint

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Comprehensive Rectal Cancer Care

Abstract

The application of neoadjuvant chemoradiotherapy to locally advanced rectal cancer is well established and reduces local recurrence. A proportion of patients will undergo complete pathological response of the tumour with no evidence of residual tumour present in the resected pathological specimen. These patients have a significantly improved prognosis in terms of both local recurrence and survival. The concept of observing these patients following chemoradiotherapy and avoiding surgery was proposed by Habra-Gama in 2004 and this approach has generated considerable interest. Considerable challenges remain however in application of this approach. The complete pathological response rate is around 15% and it is difficult to both predict the likelihood of a complete pathological response, and to identify which patients have actually undergone a complete pathological response. This chapter explores the application of ‘watch and wait’ and the associated challenges.

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  1. Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia

    Joseph C. Kong & Alexander G. Heriot

  2. University of Melbourne, Melbourne, VIC, Australia

    Alexander G. Heriot

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    Mary Kwaan

  2. University of Melbourne, Victoria, VIC, Australia

    Andrew Zbar

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Kong, J.C., Heriot, A.G. (2019). The Watch and Wait Approach After Neoadjuvant Therapy: The Australian Viewpoint. In: Kwaan, M., Zbar, A. (eds) Comprehensive Rectal Cancer Care. Springer, Cham. https://doi.org/10.1007/978-3-319-98902-0_12

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