{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:41:53Z","timestamp":1787071313052,"version":"build-2736575974"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>To evaluate outcomes of postneoadjuvant chemoradiotherapy (NACTRT) wait and watch strategy (WWS) in distal rectal cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      All consecutive patients from December 2012 to 2019 diagnosed with distal rectal tumors (T2-T4 N0-N+) having a complete or near-complete response (cCR or nCR respectively) post-NACTRT and wished for nonsurgical treatment option of WWS were included in this study. Patients were observed with 3 monthly MRI, sigmoidoscopy, and digital rectal examination (DRE) for 2 years and 6 monthly thereafter. Organ preservation rate (OPR), local regrowth rate (LRR), nonregrowth recurrence-free survival, and overall survival (OS) were estimated using the Kaplan\u2013Meier method, and factors associated with LRR were identified on univariate and multivariate analysis using the log-rank test (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05 significant).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Sixty-one consecutive patients post-NACTRT, achieving cCR [44 (72%)] and nCR [17 (28%)], respectively, were identified. All patients received pelvic radiotherapy to a dose of 45\u201350Gy conventional fractionation with concurrent Capecitabine. Additional boost dose with either external beam or brachytherapy was given to 39 patients. At a median follow-up of 39 months, 11 (18%) patients had local regrowth, of which seven were salvaged with surgery and the rest are alive with disease, as they refused surgery. The overall OPR, nonregrowth recurrence-free survival, OS was 83%, 95%, and 98%, respectively. Seven (11%) patients developed distant metastasis, of which six underwent metastasectomy and are alive and well. LRR was higher in patients with nCR versus cCR (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The wait-and-watch strategy is a safe nonoperative alternative management for selected patients attaining cCR\/nCR after NACTRT with excellent outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijc.ijc_1248_21","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:19Z","timestamp":1750982419000},"page":"76-81","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Nonoperative management in low-lying rectal cancers undergoing chemoradiation"],"prefix":"10.4103","volume":"62","author":[{"given":"Debanjali","family":"Datta","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reena","family":"Engineer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avanish","family":"Saklani","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwin","family":"D\u2019souza","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, 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