The evaluation of follow-up strategies of watch-and-wait patients with a complete response after neoadjuvant therapy in rectal cancer

Hester E. Haak, Jan Zmuc, Doenja M. J. Lambregts, Regina G. H. Beets-Tan, Jarno Melenhorst, Geerard L. Beets, Monique Maas*, Dutch Watch-and-Wait Consortium

*Corresponding author for this work

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Aim Many of the current follow-up schedules in a watch-and-wait approach include very frequent MRI and endoscopy examinations to ensure early detection of local regrowth (LR). The aim of this study was to analyse the occurrence and detection of LR in a watch-and-wait cohort and to suggest a more efficient follow-up schedule.

Method Rectal cancer patients with a clinical complete response after neoadjuvant therapy were prospectively and retrospectively included in a multicentre watch-and-wait registry between 2004 and 2018, with the current follow-up schedule with 3-monthly endoscopy and MRI in the first year and 6 monthly thereafter. A theoretical comparison was constructed for the detection of LR in the current follow-up schedule against four other hypothetical schedules.

Results In all, 50/304 (16%) of patients developed a LR. The majority (98%) were detected at

Conclusion The optimal follow-up schedule for a watch-and-wait policy in patients with a clinical complete response after chemoradiation for rectal cancer should include frequent endoscopy and to a lesser degree MRI in the first 2 years. Longer intervals, up to 12 months, can be considered after 2 years.

Original languageEnglish
Pages (from-to)1785-1792
Number of pages8
JournalColorectal Disease
Issue number7
Publication statusPublished - Jul 2021


  • chemoradiotherapy
  • clinical complete response
  • follow&#8208
  • up
  • organ preservation
  • rectal cancer
  • watch&#8208
  • and&#8208
  • wait

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