Patient and multidisciplinary team perspectives on watch and wait in rectal cancer.
Helen MohanMohamed A RabieCiaran WalshDeena HarjiPaul SuttonIan GehIan JacksonEmma HelbrenMartyn EvansJohn T JenkinsPublished in: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland (2023)
This article adopts a multidisciplinary approach, including surgery, oncology, radiology and patient perspectives, to discuss the key points of debate surrounding a watch and wait approach. In an era of shared decision-making, discussion of watch and wait as an option in the context of complete clinical response is appropriate, although it is not the gold standard treatment. Key challenges are the difficulty in assessing for a complete clinical response, prediction of recurrence and access to timely diagnostics for surveillance. Salvage surgery has good results if regrowth is detected early but does have imperfect outcomes, with only a 90% salvage rate. Good communication with patients about the risks and alternatives is essential. Patients undergoing watch and wait should ideally be enrolled in prospective registries or clinical trials.
Keyphrases
- minimally invasive
- clinical trial
- patients undergoing
- coronary artery bypass
- end stage renal disease
- case report
- palliative care
- ejection fraction
- newly diagnosed
- quality improvement
- peritoneal dialysis
- surgical site infection
- artificial intelligence
- type diabetes
- randomized controlled trial
- coronary artery disease
- adipose tissue
- squamous cell carcinoma
- metabolic syndrome
- human health
- skeletal muscle
- combination therapy
- insulin resistance
- climate change