"Watch and Wait" After Neo-adjuvant Chemoradiotherapy for Primary Locally Advanced Rectal Cancer.

  • End date
    Dec 31, 2028
  • participants needed
  • sponsor
    Helse Stavanger HF
Updated on 27 January 2021
adenocarcinoma of rectum


Among patients treated for locally advanced rectal cancer with neo-adjuvant radio-chemotherapy, about 15% will have complete clinical response in terms of no visible tumor or ulcerations on the site of the primary tumor, or whitening of the rectal wall or telangiectasia. In this Norwegian national multicenter observational study, patients with complete clinical response (cCR) after neo-adjuvant treatment for rectal cancer as defined by national guidelines, will be invited to a Watch&Wait program with a specially designed follow-up in order to see if the tumor has disappeared permanently, or if there is regrowth of the tumor. Primary endpoint is the true regrowth rate in an unselected national cohort of patients.

Condition Colorectal Cancer, Rectal Cancer, Colon Cancer Screening, Colon cancer; rectal cancer, rectal carcinoma
Clinical Study IdentifierNCT03402477
SponsorHelse Stavanger HF
Last Modified on27 January 2021


Yes No Not Sure

Inclusion Criteria

Histologically verified adenocarcinoma of the rectum within 15 cm from the anal verge measured by rigid proctoscopy
Patients who have completed neoadjuvant treatment according to national guidelines for rectal cancer, i.e., radiotherapy or chemo-radiotherapy (at least 40 Gy) or short-course radiotherapy combined with chemotherapy
Patients aged 18 years of age are eligible for inclusion. However, patients aged 40 years are recommended to undergo surgery on the theoretical base of a possibly more aggressive tumour disease in this age group, and will be asked to participate in the study by consenting to recording of data. Those patients who insist on W&W approach after careful consideration and well-documented informed consent are eligible for entering the W&W protocol
Given informed consent
Stage I-III rectal cancer; however, patients with limited liver metastases who undergo primary liver surgery as part of a "liver first" treatment approach may be included

Exclusion Criteria

Patients without cCR
Patients unable to give informed consent
Patients with short course radiotherapy (5x5 Gy) without additional chemotherapy, or patients receiving less than 40 Gy in long course CRT
Patients with cCR but with increasing tumour growth on MRI after preoperative treatment
Patients with metastatic disease at the time of diagnosis with the exception of those who are eligible for "liver first" treatment approach as part of an intention to cure approach
Patients previously diagnosed and treated for malignant disease in the pelvic region with radio- or chemoradiotherapy
Other circumstances that may interfere with successful participation in the W&W protocol
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