• Stefi Nordkamp, Floor Piqeur, Kim van den Berg, Jip L Tolenaar, Irene E G van Hellemond, Geert-Jan Creemers, Mark Roef, Gesina van Lijnschoten, Jeltsje S Cnossen, NieuwenhuijzenGrard A PGAP0000-0002-5837-5513Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands., Johanne G Bloemen, Liën Coolen, Joost Nederend, Heike M U Peulen, RuttenHarm J THJTDepartment of Surgery, Catharina Hospital, Eindhoven, the Netherlands.Faculty of Health, Medicine and Life Sciences, GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands., and BurgerJacobus W AJWADepartment of Surgery, Catharina Hospital, Eindhoven, the Netherlands..
• Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands.
• Br J Surg. 2023 Jul 17; 110 (8): 950957950-957.

BackgroundFor patients with locally recurrent rectal cancer, it is an ongoing pursuit to establish factors predicting or improving oncological outcomes. In locally advanced rectal cancer, a pCR appears to be associated with improved outcomes. The aim of this retrospective cohort study was to compare the oncological outcomes of patients with locally recurrent rectal cancer with and without a pCR.MethodsPatients who underwent neoadjuvant treatment and surgery for locally recurrent rectal cancer with curative intent between January 2004 and June 2020 at a tertiary referral hospital were analysed. Primary outcomes included overall survival, disease-free survival, metastasis-free survival, and local re-recurrence-free survival, stratified according to whether the patient had a pCR.ResultsOf a total of 345 patients, 51 (14.8 per cent) had a pCR. Median follow-up was 36 (i.q.r. 16-60) months. The 3-year overall survival rate was 77 per cent for patients with a pCR and 51.1 per cent for those without (P < 0.001). The 3-year disease-free survival rate was 56 per cent for patients with a pCR and 26.1 per cent for those without (P < 0.001). The 3-year local re-recurrence-free survival rate was 82 and 44 per cent respectively (P < 0.001). Surgical procedures (for example soft tissue, sacrum, and urogenital organ resections) and postoperative complications were comparable between patients with and without a pCR.ConclusionThis study showed that patients with a pCR have superior oncological outcomes to those without a pCR. It may therefore be safe to consider a watch-and-wait approach in highly selected patients, potentially improving quality of life by omitting extensive surgical procedures without compromising oncological outcomes.© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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