A Non-Operative Approach to Rectal Cancer after Chemo-Radiotherapy: Case Series and Review

INTRODUCTION: Chemotherapy administered concurrently with radiotherapy for locally-advanced rectal cancer prior to surgery is a standard of care approach. A fraction of patients after chemo-radiotherapy achieve pathological complete remission. Our aim was to evaluate patients treated only with a non-operative approach of only chemo-radiotherapy followed by observation at a community cancer center. METHODS: Medical charts of the patients who were treated for locally advanced rectal cancer and treated with chemo-radiation therapy alone from January 1, 2000 through May 1, 2017 at a Midwestern cancer center were reviewed. The clinical course of the patients was followed from the time of the cancer diagnosis through their last available clinical record. RESULTS: A series of three cases were reviewed with locally-advanced distal rectal cancers treated with a non-operative approach. CONCLUSIONS: Watchful waiting for patients with locally advanced distal rectal cancer who have complete clinical response with neoadjuvant chemotherapy and radiation might be an effective treatment strategy.