Cómo citar
Resumen
El tratamiento del cáncer de recto sigue siendo principalmente quirúrgico, sin embargo, este manejo conlleva una serie de comorbilidades y posibles complicaciones para el paciente, tales como: incontinencia fecal o urinaria, disfuncional sexual y una alta posibilidad de una ostomía permanente y sus complicaciones. No obstante, se ha visto que hasta un cuarto de las piezas patológicas muestran una respuesta patológica completa posterior a la neoadyuvancia. Es por esto que, con la idea de evitar estas complicaciones luego de una cirugía, nace la idea del manejo Watch and Wait, donde, si luego de la neoadyuvancia el paciente obtiene una respuesta completa al tratamiento, pasa a un programa de observación minuciosa, y de mantenerse, evitaría una cirugía radical, que en diversos estudios ha mostrado resultados oncológicos similares al manejo quirúrgico. Al ser un manejo novedoso, requiere dejar en claro diversos aspectos, entre ellos: el paciente que más se beneficiaría, la terapia neoadyuvante a realizar, la evaluación de la respuesta clínica y el seguimiento del paciente.
Palabras clave
Citas
Pinto JC, Pereira AD, Pimenta A, Pedro C, Fernández G, Marques I, et al. Low rectal cancer treatment strategies: a cohort study assessing watch and wait. J Cancer Res Clin Oncol. Oct, 2020;146(10):2631–8.
López-Campos F, Martín-Martín M, Fornell-Pérez R, García-Pérez JC, Die-Trill J, Fuentes-Mateos R, et al. Watch and wait approach in rectal cancer: Current controversies and future directions. World J Gastroenterol. Aug 07, 2020;26(29):4218–39.
Glynne-Jones R, Hughes R. Complete Response after Chemoradiotherapy in Rectal Cancer (Watch-and-Wait): Have we Cracked the Code? Clin Oncol (R Coll Radiol). Feb, 2016;28(2):152–60.
Tulin A, Nitipir C, Slavu I, Braga V, Mihaila D, Alecu L. Watch and Wait Strategy for Rectal Cancer: 15 Years After the First Published Study. Are We any Closer to the Non-operative Management of Rectal Cancer? Revista Chirurgia [Internet]. 2019 [cited Aug 27, 2022];114(2):174. Available from: http://www.revistachirurgia.ro/pdfs/2019-2-174.pdf
Fokas E, Appelt A, Glynne-Jones R, Beets G, Pérez R, García-Aguilar J, et al. International consensus recommendations on key outcome measures for organ preservation after (chemo)radiotherapy in patients with rectal cancer. Nat Rev Clin Oncol [Internet]. Dec, 2021 [cited Sep 1, 2022];18(12):805–16. Available from: https://www.nature.com/articles/s41571-021-00538-5
Bernier L, Balyasnikova S, Tait D, Brown G. Watch-and-Wait as a Therapeutic Strategy in Rectal Cancer. Curr Colorectal Cancer Rep [Internet]. Apr, 2018 [cited Aug 29, 2022];14(2):37–55. Available from: http://link.springer.com/10.1007/s11888-018-0398-5
Haak HE, Maas M, Lambregts DMJ, Beets-Tan RGH, Beets GL, Melenhorst J, et al. Is watch and wait a safe and effective way to treat rectal cancer in older patients? European Journal of Surgical Oncology [Internet]. Mar, 2020 [cited Sep 1, 2022];46(3):358–62. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0748798320300056
Glynne-Jones R, Wyrwicz L, Tiret E, Brown G, Rödel C, Cervantes A, et al. Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology [Internet]. Jul, 2017 [cited Jul 31, 2022];28:iv22–40. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0923753419421522
Wei IH, García-Aguilar J. Non-operative management of rectal cancer: understanding tumor biology. Minerva Chir [Internet]. Nov, 2018 [cited Sep 1, 2022];73(6). Available from: https://www.minervamedica.it/index2.php?show=R06Y2018N06A0601
Capdevila J, Gómez MA, Guillot M, Páez D, Pericay C, Safont MJ, et al. SEOM-GEMCAD-TTD clinical guidelines for localized rectal cancer (2021). Clin Transl Oncol [Internet]. Apr, 2022 [cited Jul 31, 2022];24(4):646–57. Available from: https://link.springer.com/10.1007/s12094-022-02816-9
Cercek A, Roxburgh CSD, Strombom P, Smith JJ, Temple LKF, Nash GM, et al. Adoption of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer. JAMA Oncol [Internet]. Jun 14, 2018 [cited Aug 28, 2022];4(6):e180071. Available from: http://oncology.jamanetwork.com/article.aspx?doi=10.1001/jamaoncol.2018.0071
Das P, Skibber JM, Rodríguez-Bigas MA, Feig BW, Chang GJ, Wolff RA, et al. Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer. Cancer. May 1, 2007;109(9):1750–5.
Yuval JB, Thompson HM, García-Aguilar J. Organ Preservation in Rectal Cancer. J Gastrointest Surg [Internet]. Aug, 2020 [cited Sep 2, 2022];24(8):1880–8. Available from: https://link.springer.com/10.1007/s11605-020-04583-w
Habr-Gama A, São Julião G, Vailati B, Castro I, Raffaele D. Management of the Complete Clinical Response. Clinics in Colon and Rectal Surgery [Internet]. Nov, 2017 [cited 2022 Sep 2];30(05):387–94. Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1606116
Al-Najami I, Jones HJ, Dickson EA, Muirhead R, Deding U, James DR, et al. Rectal cancer: Watch-and-wait and continuing the rectal-preserving strategy with local excision for incomplete response or limited regrowth. Surg Oncol. Jun, 2021;37:101574.
Fernández LM, Figueiredo NL, Habr-Gama A, São Julião GP, Vieira P, Vailati BB, et al. Salvage Surgery With Organ Preservation for Patients With Local Regrowth After Watch and Wait: Is It Still Possible? Dis Colon Rectum. Aug, 2020;63(8):1053–62.
Geubels BM, Meyer VM, van Westreenen HL, Beets GL, Grotenhuis BA, On Behalf Of The Dutch Watch And Wait Consortium null. Role of Local Excision for Suspected Regrowth in a Watch and Wait Strategy for Rectal Cancer. Cancers (Basel). Jun 23, 2022;14(13):3071.
Pascual-Russo A, Milito D, Facio L, Furia M, Forestier V, Iseas S, et al. Mejor calidad de vida y menor incontinencia fecal en pacientes con cáncer de recto con la estrategia de seguimiento watch and wait. Revista de Gastroenterología de México [Internet]. Oct, 2021 [citado el 03 de setiembre, 2022];86(4):340–7. Disponible a partir de: https://linkinghub.elsevier.com/retrieve/pii/S0375090620300902
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
Derechos de autor 2022 Array