An initial watch and wait approach is a valid strategy for selected patients with newly diagnosed metastatic colorectal cancer
Annals of Oncology, 06/26/2012
Voskoboynik M et al. – Our study demonstrates that a substantial minority of patients underwent an initial watch and wait approach. Ultimately, they received a similar treatment exposure to patients treated immediately and the survival outcomes were not compromised.Methods
- We prospectively collected data regarding clinician treatment recommendations for patients with newly diagnosed mCRC in addition to subsequent treatment and outcomes.
- Follow-up and management was according to standard protocols.
- Seven hundred and thirty-six patients (59.1% male, 40.9% female) with mCRC (January 2003–December 2010) were analysed; the median age was 67.9 years (range 26.2–95.5).
- Three hundred and seventy-seven patients (51.2%) received immediate chemotherapy.
- For 133 (18.1%), treatment was considered inappropriate.
- 34 patients (4.6%) declined therapy. For 192 (26.1%), a watch and wait policy was adopted and 168 (87.5%) of these received treatment, at a median of 3.7 months (range 2–35 months) from diagnosis.
- Compared with patients immediately treated, the number receiving all active chemotherapy agents (30.4 versus 39.3%) was similar and median survival (27 versus 17 months, P = 0.0008) was superior.