Home Gastroenterology ASCO: Option to Skip Surgery Viable for Some With Rectal CA

ASCO: Option to Skip Surgery Viable for Some With Rectal CA

Just chemo/radiation was as effective in half of those with earliest stage of disease

TUESDAY, Jan. 13, 2015 (HealthDay News) — Some rectal cancer patients may fare just as well by forgoing surgery in favor of chemotherapy/radiation and “watchful waiting,” according to research presented Monday at the American Society of Clinical Oncology’s annual Gastrointestinal Cancers Symposium, held from Jan. 15 to 17 in San Francisco.

The finding is based on a review of data from 145 rectal cancer patients, all of whom had been diagnosed with stage I, II, or III disease. All were treated with chemotherapy and radiation between 2006 and 2014 at the Memorial Sloan-Kettering Cancer Center in New York City. But about half had surgery while the others held off from the procedure in favor of rigorous tracking of their disease progression — “watchful waiting.”

Ultimately, nearly three-quarters of the non-surgery group remained cancer-free approximately four years later, while about one-quarter had to undergo surgery to treat tumor recurrence. Overall, the four-year survival rate was 91 percent in the no-surgery group versus 95 percent in the surgery group.

“We believe that our results will encourage more doctors to consider this ‘watch-and-wait’ approach in patients with clinical complete response as an alternative to immediate rectal surgery, at least for some patients,” senior study author Philip Paty, M.D., a surgical oncologist at the Memorial Sloan-Kettering Cancer Center, said in a news release from the American Society of Clinical Oncology. The study authors said that the type of patients who would most likely do well without immediate surgery are the up to 50 percent of stage I patients whose tumors typically disappear altogether following initial chemotherapy/radiation treatment. That figure hovers at between 30 percent and 40 percent among stage II and III patients.

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