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<p>The standard treatment of locally advanced rectal cancer with rectal or abdominoperineal resection and total mesorectal excision (TME) after neoadjuvant therapy is often associated with significant functional impairment. Therefore, in recent years, the watch and wait approach has been developed for patients who have achieved complete clinical and radiological remission after neoadjuvant therapy. In this approach, a surgical intervention is omitted under intensive monitoring. Based on current data, this procedure is oncologically safe. While local tumor control is less favorable than after surgical treatment, this does not appear to be a&#xa0;disadvantage, as salvage surgery with TME can generally be performed and the prognosis seems comparable to that of primary TME.</p><p>To assess and monitor clinical complete remission, digital rectal examination, endoscopy, and pelvic magnetic resonance imaging (MRI) in T2-weighted and diffusion-weighted images are used. Assessing clinical remission can be challenging, so the examiners should possess the necessary expertise. As so-called regrowth occurs primarily within the first 2–3 years, close monitoring is particularly necessary during this period.</p>

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Watch-and-wait beim Rektumkarzinom

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月23日

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  • Birgit Bittorf

摘要

The standard treatment of locally advanced rectal cancer with rectal or abdominoperineal resection and total mesorectal excision (TME) after neoadjuvant therapy is often associated with significant functional impairment. Therefore, in recent years, the watch and wait approach has been developed for patients who have achieved complete clinical and radiological remission after neoadjuvant therapy. In this approach, a surgical intervention is omitted under intensive monitoring. Based on current data, this procedure is oncologically safe. While local tumor control is less favorable than after surgical treatment, this does not appear to be a disadvantage, as salvage surgery with TME can generally be performed and the prognosis seems comparable to that of primary TME.

To assess and monitor clinical complete remission, digital rectal examination, endoscopy, and pelvic magnetic resonance imaging (MRI) in T2-weighted and diffusion-weighted images are used. Assessing clinical remission can be challenging, so the examiners should possess the necessary expertise. As so-called regrowth occurs primarily within the first 2–3 years, close monitoring is particularly necessary during this period.