Organ Preservation and Survival by Clinical Response Grade in Patients With Rectal Cancer Treated With Total Neoadjuvant Therapy

This article stresses the importance of assessing tumor response grade utilizing a 3-tier grading schema after Total Neoadjuvant Therapy (TNT) in patients with locally advanced rectal cancer as part of the Watch and Wait strategy.

Abstract

Importance  Assessing clinical tumor response following completion of total neoadjuvant therapy (TNT) in patients with locally advanced rectal cancer is paramount to select patients for watch-and-wait treatment.

Objective  To assess organ preservation (OP) and oncologic outcomes according to clinical tumor response grade.

Design, Setting, and Participants  This was a secondary analysis of the Organ Preservation in Patients with Rectal Adenocarcinoma trial, a phase 2, nonblinded, multicenter, randomized clinical trial. Randomization occurred between April 2014 and March 2020. Eligible participants included patients with stage II or III rectal adenocarcinoma. Data analysis occurred from March 2022 to July 2023.