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No sign of tumour on examination, endoscopy, and MRI after treatment, without surgery to confirm it. It is the basis of organ-preservation strategies.
Defined by digital rectal exam, endoscopy (flat white scar), and MRI (TRG1) in rectal cancer; sustained cCR at 12 months is the primary endpoint of AZUR-1. Watch-and-wait after chemoradiation (OPRA, IWWD) and after immunotherapy (dostarlimab) preserve the rectum; regrowth is usually salvageable with surgery.
For mismatch repair-deficient rectal cancer, six months of a single antibody now replaces chemotherapy, radiotherapy and an operation, and the same appears to be true for early-stage mismatch repair-deficient cancers of other organs.
Organ preservation became a plan rather than an accident: consolidation chemotherapy after chemoradiotherapy gives the best chance of keeping the rectum, and salvage surgery after regrowth does not appear to cost survival.
The origin of organ preservation in rectal cancer. Twenty years later OPRA made it a planned strategy and the dostarlimab series made it the expected outcome in mismatch repair-deficient disease.
Shares AZUR-1, Nonoperative management of mismatch repair-deficient tumors, Organ preservation in patients with rectal adenocarcinoma treated with total neoadjuvant therapy (OPRA), Randomise organ preservation against surgery in mismatch repair-proficient rectal cancer, with bowel function as a co-primary endpoint.
Shares Watch and wait after chemoradiotherapy for rectal cancer, OPRA, Organ preservation in patients with rectal adenocarcinoma treated with total neoadjuvant therapy (OPRA), Organ preservation (watch-and-wait, bladder-sparing, larynx preservation).
Shares OPRA, Organ preservation in patients with rectal adenocarcinoma treated with total neoadjuvant therapy (OPRA), Randomise organ preservation against surgery in mismatch repair-proficient rectal cancer, with bowel function as a co-primary endpoint, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation.
Shares Watch and wait after chemoradiotherapy for rectal cancer, OPRA, Organ preservation in patients with rectal adenocarcinoma treated with total neoadjuvant therapy (OPRA), Organ preservation (watch-and-wait, bladder-sparing, larynx preservation).
Shares Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results, Organ preservation (watch-and-wait, bladder-sparing, larynx preservation), Randomise organ preservation against surgery in mismatch repair-proficient rectal cancer, with bowel function as a co-primary endpoint, Rectal cancer.
Shares International Watch & Wait Database, CAO/ARO/AIO-12, Randomise organ preservation against surgery in mismatch repair-proficient rectal cancer, with bowel function as a co-primary endpoint, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation.
Shares CROSS chemoradiation → surgery → adjuvant nivolumab if residual disease, Organ preservation as the default after complete response in oesophageal cancer, SANO, Pathologic complete response (pCR).
Shares International Watch & Wait Database, Randomise organ preservation against surgery in mismatch repair-proficient rectal cancer, with bowel function as a co-primary endpoint, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Rectal cancer.