Adoption of organ preservation and surgeon variability for patients with rectal cancer does not correlate with worse survival Journal Article
| Authors: | Kim, J. K.; Thompson, H.; Jimenez-Rodriguez, R. M.; Wu, F.; Sanchez-Vega, F.; Nash, G. M.; Guillem, J. G.; Paty, P. B.; Wei, I. H.; Pappou, E. P.; Widmar, M.; Weiser, M. R.; Smith, J. J.; Garcia-Aguilar, J. |
| Article Title: | Adoption of organ preservation and surgeon variability for patients with rectal cancer does not correlate with worse survival |
| Abstract: | Background and Objectives: Watch-and-wait is variably adopted by surgeons and the impact of this on outcomes is unknown. We compared the disease-free survival and organ preservation rates of locally advanced rectal cancer patients treated by expert colorectal surgeons at a comprehensive cancer center. Methods: This study included retrospective data on patients diagnosed with stage II/III rectal adenocarcinoma from January 2013 to June 2017 who initiated neoadjuvant therapy (either with chemoradiation, chemotherapy, or a combination of both) and were treated by an expert colorectal surgeon. Results: Overall, 444 locally advanced rectal cancer patients managed by five surgeons were included. Tumor distance from the anal verge, type of neoadjuvant therapy, and organ preservation rates varied by treating surgeon. There was no difference in disease-free survival after stratifying by the treating surgeon (p = 0.2). On multivariable analysis, neither the type of neoadjuvant therapy nor the treating surgeon was associated with disease-free survival. Conclusions: While neoadjuvant therapy type and organ preservation rates varied among surgeons, there were no meaningful differences in disease-free survival. These data suggest that among expert colorectal surgeons, differing thresholds for selecting patients for watch-and-wait do not affect survival. © 2021, Society of Surgical Oncology. |
| Keywords: | adult; cancer survival; controlled study; treatment outcome; aged; cancer surgery; retrospective studies; major clinical study; advanced cancer; cancer combination chemotherapy; cancer patient; comparative study; disease free survival; neoadjuvant therapy; cancer staging; antineoplastic agent; neoplasm staging; multiple cycle treatment; neoplasm recurrence, local; pathology; retrospective study; cancer center; watchful waiting; tumor recurrence; surgeon; clinical evaluation; organ preservation; rectum carcinoma; rectal neoplasms; rectum tumor; chemoradiotherapy; managed care; surgeons; adoption; capecitabine plus oxaliplatin; humans; human; male; female; article; high volume hospital |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 29 |
| Issue: | 2 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2022-02-01 |
| Start Page: | 1172 |
| End Page: | 1179 |
| Language: | English |
| DOI: | 10.1245/s10434-021-10877-3 |
| PUBMED: | 34601641 |
| PROVIDER: | scopus |
| PMCID: | PMC8727510 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 February 2022 -- Source: Scopus |
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