How and When to Practice a Wait-and-See Policy Taking Care of the Patient Safety?
A “wait-and-see” policy, also called “watch-and-wait” (W&W), refers to the approach after an apparent complete clinical remission after (chemo)radiation of a rectal cancer in which no immediate surgery is performed. The patient enters a careful follow-up programme aimed at early detection of residual disease, with the option of delayed salvage surgery when residual disease becomes apparent. A closely related approach is to perform a local excision of the remaining scar or small tumour remnant in a very good clinical response, entering a similar follow-up programme afterwards. This approach will not be discussed extensively in this chapter, only when relevant for comparison with W&W. A clinical situation that will not be discussed in this chapter is when after a polypectomy or a surgical local excision of a prognostically favourable very early tumour it is decided not to perform completion surgery but rather to start a surveillance programme.
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