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A meta-analysis of the watch-and-wait strategy versus total mesorectal excision for rectal cancer exhibiting complete clinical response after neoadjuvant chemoradiotherapy
Yu, Guilin1; Lu, Wenqing2; Jiao, Zhouguang3; Qiao, Jun4; Ma, Shiyang4; Liu, Xin4
2021-10-18
Source PublicationWORLD JOURNAL OF SURGICAL ONCOLOGY
Volume19Issue:1Pages:12
AbstractBackground Some clinical researchers have reported that patients with cCR (clinical complete response) status after neoadjuvant chemoradiotherapy (nCRT) could adopt the watch-and-wait (W&W) strategy. Compared with total mesorectal excision (TME) surgery, the W&W strategy could achieve a similar overall survival. Could the W&W strategy replace TME surgery as the main treatment option for the cCR patients? By using the meta-analysis method, we evaluated the safety and efficacy of the W&W strategy and TME surgery for rectal cancer exhibiting cCR after nCRT. Methods We evaluated two treatment strategies for rectal cancer with cCR after nCRT up to July 2021 by searching the Cochrane Library, PubMed, Wanfang, and China National Knowledge Infrastructure (CNKI) databases. Clinical data for primary outcomes (local recurrence, cancer-related death and distant metastasis), and secondary outcomes (disease-free survival (DFS) and overall survival (OS)) were collected to evaluate the efficacy and safety in the two groups. Results We included nine studies with 818 patients in the meta-analysis, and there were five moderate-quality studies and four high-quality studies. A total of 339 patients were in the W&W group and 479 patients were in the TME group. The local recurrence rate in the W&W group was greater than that in the TME group in the fixed-effects model (OR 8.54, 95% CI 3.52 to 20.71, P < 0.001). The results of other outcomes were similar in the two groups. Conclusion The local recurrence rate of the W&W group was greater than that in the TME group, but other results were similar in the two groups. With the help of physical examination and salvage therapy, the W&W strategy could achieve similar treatment effects with the TME approach.
KeywordWatch-and-wait Complete clinical response Total mesorectal excision Rectal cancer Meta-analysis
DOI10.1186/s12957-021-02415-y
Language英语
WOS KeywordORGAN PRESERVATION ; NONOPERATIVE MANAGEMENT ; LOCAL EXCISION ; GRECCAR 2 ; CHEMORADIATION ; THERAPY ; SURVEILLANCE ; SURGERY ; QUALITY
Funding ProjectCancer Hospital of China Medical University ; Natural Science Foundation of Liaoning Province Fund of China[2020-MS-060] ; Pilot Cancer Research Fund Project of CSCO (Chinese society of clinical oncology)[Y-2019AZQN-0035] ; Dalian University of Technology-Liaoning Cancer Hospital ; Institute Cross Joint Fund[LD202130]
WOS Research AreaOncology ; Surgery
WOS SubjectOncology ; Surgery
Funding OrganizationCancer Hospital of China Medical University ; Natural Science Foundation of Liaoning Province Fund of China ; Pilot Cancer Research Fund Project of CSCO (Chinese society of clinical oncology) ; Dalian University of Technology-Liaoning Cancer Hospital ; Institute Cross Joint Fund
WOS IDWOS:000708487500001
PublisherBMC
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Document Type期刊论文
Identifierhttp://ir.ipe.ac.cn/handle/122111/50616
Collection中国科学院过程工程研究所
Corresponding AuthorLiu, Xin
Affiliation1.China Med Univ, Liaoning Canc Hosp & Inst, Dept Gen Surg, Canc Hosp, 44 Xiaoheyan Rd, Shenyang 110042, Liaoning, Peoples R China
2.Hebei Univ, Sch Life Sci, Baoding 071002, Hebei, Peoples R China
3.Chinese Acad Sci, Inst Proc Engn, Beijing 100190, Peoples R China
4.China Med Univ, Liaoning Canc Hosp & Inst, Dept Colorectal Surg, Canc Hosp, 44 Xiaoheyan Rd, Shenyang 110042, Liaoning, Peoples R China
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Yu, Guilin,Lu, Wenqing,Jiao, Zhouguang,et al. A meta-analysis of the watch-and-wait strategy versus total mesorectal excision for rectal cancer exhibiting complete clinical response after neoadjuvant chemoradiotherapy[J]. WORLD JOURNAL OF SURGICAL ONCOLOGY,2021,19(1):12.
APA Yu, Guilin,Lu, Wenqing,Jiao, Zhouguang,Qiao, Jun,Ma, Shiyang,&Liu, Xin.(2021).A meta-analysis of the watch-and-wait strategy versus total mesorectal excision for rectal cancer exhibiting complete clinical response after neoadjuvant chemoradiotherapy.WORLD JOURNAL OF SURGICAL ONCOLOGY,19(1),12.
MLA Yu, Guilin,et al."A meta-analysis of the watch-and-wait strategy versus total mesorectal excision for rectal cancer exhibiting complete clinical response after neoadjuvant chemoradiotherapy".WORLD JOURNAL OF SURGICAL ONCOLOGY 19.1(2021):12.
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