Watch & wait - Post neoadjuvant imaging for rectal cancer Review
| Authors: | El Homsi, M.; Bercz, A.; Chahwan, S.; Fernandes, M. C.; Javed-Tayyab, S.; Golia Pernicka, J. S.; Nincevic, J.; Paroder, V.; Ruby, L.; Smith, J. J.; Petkovska, I. |
| Review Title: | Watch & wait - Post neoadjuvant imaging for rectal cancer |
| Abstract: | Rectal cancer management has evolved over the past decade with the emergence of total neoadjuvant therapy (TNT). For select patients who achieve a clinical complete response following TNT, organ preservation by means of the watch-and-wait (WW) strategy is an increasingly adopted alternative that preserves rectal function and quality of life without compromising oncologic outcomes. Recently, published 5-year results from the OPRA trial demonstrated that organ preservation can be achieved in approximately half of patients managed with the WW strategy, with most local regrowth events occurring within two years. Considering the potential for local regrowth, the implementation of the WW strategy mandates rigorous clinical and radiographic surveillance. Magnetic resonance imaging (MRI) serves as the conventional imaging modality for local staging and surveillance of rectal cancer given its excellent soft-tissue resolution. This review will discuss the current evidence for the WW strategy and the role of restaging rectal MRI in determining patient eligibility for this strategy. Restaging rectal MRI acquisition parameters and treatment response assessment, including important factors to assess, pitfalls, and classification systems, will be discussed in the context of the WW strategy. © 2024 Elsevier Inc. |
| Keywords: | treatment outcome; overall survival; review; treatment planning; cancer radiotherapy; disease free survival; neoadjuvant therapy; cancer staging; nuclear magnetic resonance imaging; magnetic resonance imaging; antineoplastic agent; quality of life; clinical protocol; drug effect; soft tissue; fibrosis; survival time; lymph node; organ preservation; clinical effectiveness; endoscopy; rectum cancer; diseases; rectal cancer; mucin; anus sphincter; complete response; imaging modality; neoadjuvant chemoradiotherapy; conventional imaging; human; cancer management; watch and wait; watches |
| Journal Title: | Clinical Imaging |
| Volume: | 110 |
| ISSN: | 0899-7071 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2024-05-31 |
| Start Page: | 110166 |
| Language: | English |
| DOI: | 10.1016/j.clinimag.2024.110166 |
| PROVIDER: | scopus |
| PUBMED: | 38669916 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Iva Petkovska -- Source: Scopus |
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