PMID- 32926663
OWN - NLM
STAT- MEDLINE
DCOM- 20210624
LR  - 20210624
IS  - 2688-1535 (Electronic)
IS  - 2688-1527 (Linking)
VI  - 17
IP  - 2
DP  - 2021 Feb
TI  - Pilot Study of Patients' Preferences for Immediate Resection Versus a Watch and 
      Wait Approach After Neoadjuvant Chemoradiation for Locally Advanced Rectal 
      Cancer.
PG  - e149-e157
LID - 10.1200/OP.20.00158 [doi]
AB  - PURPOSE: In patients with rectal cancer who achieve a clinical complete response 
      to neoadjuvant chemoradiation, it may be reasonable to adopt a watch-and-wait 
      (W&W) strategy rather than proceed to immediate resection of the rectum. Patient 
      preferences for this strategy are unknown. The primary aim of the current study 
      was to determine the feasibility of assessing hypothetical recurrence and 
      survival differences that relevant patients would tolerate to avoid immediate 
      resection of the rectum. A secondary aim included estimating patients' tolerance 
      thresholds and the factors that might predict them. METHODS: We developed a 
      study-specific written questionnaire based on a previously validated instrument. 
      Hypothetical time tradeoff tasks were used to determine the recurrence rate 
      patients would accept to adopt a W&W strategy and the survival benefit that would 
      be needed to justify choosing immediate resection over W&W. Feasibility was 
      measured on the basis of response rate, the stated ease of completion and the 
      satisfaction of task, and time used. RESULTS: Twenty of 31 potentially eligible 
      patients completed the study-specific questionnaire. The majority of respondents 
      felt that questions were clear (70%) and not hard to understand (65%). The median 
      acceptable recurrence risk to adopt a W&W strategy was 20% (interquartile range 
      [IQR], 10%-35%). Patients required a median of 2.0 extra years of survival (IQR, 
      1.0-3.0 years) over a baseline 7.0 years, and they required a median extra 10% 
      (IQR, 4%-19%) over baseline 70% survival rates to justify immediate resection. 
      CONCLUSION: Measuring the preferences of patients with rectal cancer using time 
      tradeoff methods seemed to be feasible. Larger studies are needed to confirm how 
      acceptable a W&W strategy would be for relevant patients.
FAU - Gunjur, Ashray
AU  - Gunjur A
AD  - Department of Medical Oncology, Austin Health, Melbourne, NSW, Australia.
FAU - Chazan, Grace
AU  - Chazan G
AD  - Peter MacCallum Cancer Centre, Melbourne, NSW, Australia.
FAU - Newnham, Genni
AU  - Newnham G
AD  - Oncology and Cancer Services, St Vincent's Hospital Melbourne, Melbourne, NSW, 
      Australia.
FAU - McLachlan, Sue-Anne
AU  - McLachlan SA
AD  - Oncology and Cancer Services, St Vincent's Hospital Melbourne, Melbourne, NSW, 
      Australia.
AD  - Department of Medicine, University of Melbourne, Melbourne, NSW, Australia.
LA  - eng
PT  - Journal Article
DEP - 20200914
PL  - United States
TA  - JCO Oncol Pract
JT  - JCO oncology practice
JID - 101758685
SB  - IM
MH  - Humans
MH  - Neoadjuvant Therapy
MH  - Neoplasm Recurrence, Local
MH  - *Patient Preference
MH  - Pilot Projects
MH  - *Rectal Neoplasms/surgery
MH  - Rectum
MH  - Watchful Waiting
EDAT- 2020/09/15 06:00
MHDA- 2021/06/25 06:00
CRDT- 2020/09/14 17:05
PHST- 2020/09/15 06:00 [pubmed]
PHST- 2021/06/25 06:00 [medline]
PHST- 2020/09/14 17:05 [entrez]
AID - 10.1200/OP.20.00158 [doi]
PST - ppublish
SO  - JCO Oncol Pract. 2021 Feb;17(2):e149-e157. doi: 10.1200/OP.20.00158. Epub 2020 
      Sep 14.