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1、Watch-and-waitapproachversussurgicalresectionafterchemoradiotherapyforpatientswithrectalcancer(theOnCoReproject):apropensity-scorematchedcohortanalysisLancetOncolPublishedOnlineDecember16,20152004.10,AnnalsofSurgery,Habr-Gama.eg265patientswithdistalrectalweretreate
2、dbyCRTwith5-FU,Leucovorinand5040cGyFive-yearOSandDFSrateswere88%and83%inResectionGroup,100%and92%inObservationGroupPurposeoncologicaloutcomesbetweenwatchandwaitandsurgicalresectionthesafetyofthewatch-and-waitThedefinitionofacCR(1)substantialdownsizingwithnoresidual
3、tumororresidualfibrosisonly(2)nosuspiciouslymphnodesonMRI(3)noresidualtumoratendoscopyoronlyasmallresidualerythematousulcerorscar(4)negativebiopsiesfromthescar,ulcer,orformertumorlocation(5)nopalpabletumor,wheninitiallypalpablewithdigitalrectalexaminationMethodsone
4、-to-onepairedcohortsofwatchandwaitversussurgicalresectionusingpropensity-scorematching（Tstage,age,andperformancestatus）primaryendpointwasDFSsecondaryendpointswasOSandcolostomy-freesurvivalMethodsCCRstandard:afterCRT8weeksormoreabsenceofresidualulceration,stenosis,o
5、rmasswithintherectumduringdigitalrectalexaminationandendoscopicexaminationMethods259patientsfromatertiarycancercentreinManchester,UKbetweenJan14,2011andApril15,2013CCR--wait-and-seepolicygroup(31)NCCR--surgicalresection(228)MethodsthreeneighbouringUKregionalcancerc
6、entres(LancashireandSouthCumbria,MerseysideandCheshire,andnorthWales)March10,2005,andJan21,2015--wait-and-seepolicygroup(98)Methodspreoperativechemoradiotherapy:45Gyin25dailyfractionswithconcurrentfluoropyrimidine-basedchemotherapyfor34daysMethodsDatainclude:TandNs
7、tages(MRI)Sex,age,BMISmokingstatus,performancestatusBaselineCEAHistologicalgradeHeightfromanalvergeMethodsStatisticalanalysiscontinuousvariables--Kruskal-WallisandWilcoxonsigned-ranktestscategoricalvariables--χ²andMcNamaratestsPvalueResultsMedianfollow-upof33months
8、(IQR19–43)44/129patientshadlocalregrowths(42patientshadmucosallesions,2patienthadsubmucosalormesorectallesions)ResultsResults31underwentsubsequen
