{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:53:40Z","timestamp":1790823220357,"version":"4.1.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100004622","name":"The Dutch Cancer Society","doi-asserted-by":"publisher","award":["10513\/2016-1"],"award-info":[{"award-number":["10513\/2016-1"]}],"id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Most reports on the outcome of Watch-and-Wait (W&amp;W) in rectal cancer come from expert centres. This study reports on a broad implementation in the Netherlands.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Material and Methods<\/jats:title>\n                  <jats:p>The process of W&amp;W implementation is described and the outcome of patients in a W&amp;W registry between 2004 and 2022 analysed (regrowth, metastases, survival, and organ preservation). Three equally sized chronological cohorts were compared to capture any differences during implementation over time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>W&amp;W was gradually implemented in 18 high-volume hospitals coordinated by a single expert centre. One thousand and eighty patients with a clinical good response after (chemo)radiotherapy were included, with a median follow-up of 42 months (95% c.i. 40 to 44). At first response evaluation, 45% had a clinical complete response (cCR) and 55% near-complete reponse (nCR). In patients with nCR, 75% eventually achieved cCR, 14% underwent local excision, 2% received additional contact X-ray brachytherapy, and 10% underwent total mesorectal excision (TME) for persistent residual disease. Three-year actuarial local regrowth incidence was 23%. Three-year organ preservation rate was 76%. The 3-year distant metastases rate and overall survival were 10% and 97%. There were no significant differences in 3-year local regrowth or distant metastases between the three consecutive cohorts. In the two more recent cohorts more patients underwent TME for residual disease (13% versus 3%), likely due to a more liberal inclusion of patients with nCR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The results of W&amp;W in rectal cancer patients in high-volume hospitals mirror those of expert centres.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znaf040","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T09:13:31Z","timestamp":1743671611000},"source":"Crossref","is-referenced-by-count":7,"title":["National implementation of Watch-and-Wait in patients with rectal cancer"],"prefix":"10.1093","volume":"112","author":[{"given":"Barbara M","family":"Geubels","sequence":"first","affiliation":[{"name":"Department of Surgery, Netherlands Cancer Institute , Amsterdam ,","place":["The Netherlands"]},{"name":"Department of Surgery, 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