Management of rectal cancer in the era of total neoadjuvant therapy and watch and wait: A multidisciplinary team discussion at the Australasian Gastro-Intestinal Trials Group (AGITG) Annual Scientific Meeting 2022

Asia Pac J Clin Oncol. 2024 Feb;20(1):71-80. doi: 10.1111/ajco.13974. Epub 2023 Jun 21.

Abstract

Rectal cancer is a common malignancy. The management of rectal cancer has recently evolved and has undergone a paradigm shift with the advent of treatment approaches such as total neoadjuvant therapy and the watch-and-wait approach. However, despite the recently available evidence, there is no consensus on the optimal management approach in the setting of locally advanced rectal cancer. To address some of the controversies, a joint multidisciplinary panel discussion was conducted at the Australasian Gastro-Intestinal Trials Group (AGITG) Annual Scientific Meeting in November 2022. Members from different subspecialties formed two panels and discussed three clinical cases in a debate format. Each case represented some of the complex issues faced by clinicians in this setting. The discussion is now presented in this manuscript, which depicts the different available management approaches and reiterates the importance of a multidisciplinary approach.

Keywords: rectal cancer; total neoadjuvant therapy; watch and wait.

MeSH terms

  • Chemoradiotherapy
  • Humans
  • Neoadjuvant Therapy*
  • Neoplasm Recurrence, Local / pathology
  • Patient Care Team
  • Rectal Neoplasms* / pathology
  • Rectal Neoplasms* / therapy
  • Treatment Outcome