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|Title:||"Watchful waiting" for metastatic colorectal cancer, antediluvian or an option to be considered again?|
|Citation:||Asia Pacific Journal of Clinical Oncology, 2012; 8(1):10-13|
|Publisher:||Blackwell Publishing Ltd.|
|Timothy J. Price, Amanda R. Townsend, Carol Beeke, Sarwan Bishnoi, Robert Padbury, Guy Maddern and Christos S. Karapetis|
|Abstract:||AIM: The role of chemotherapy in metastatic colorectal cancer (mCRC) is firmly established and the option of watchful waiting (WW) has become an alternative rarely considered. However, there may be a group of patients who are diagnosed with low volume and asymptomatic disease and who may be suitable for a WW plan. METHODS: From the South Australian Cancer Registry for mCRC we examined cancer characteristics and outcomes of patients who were suitable for chemotherapy but had their treatment delayed by more than 3 months from diagnosis of metastatic disease. RESULTS: Data from 417 mCRC patients who received chemotherapy as first intervention have been entered in the Registry to date and 38 (9.1%) had chemotherapy commencement delayed by more than 3 months from diagnosis. Their median age was 76.7 years (range 38–85). Overall 87% of patients had metachronous metastatic cancer with a median time to recurrence of 2.1 years (range 0.53–7.71) and 65.5% had single organ metastasis. Median delay from the diagnosis of metastatic disease to chemotherapy was 5.03 months (range 3–28). The median survival has yet to be reached. The 2-year overall survival is 65%. CONCLUSION: We found that almost 10% of all patients with mCRC had a delay in the initiation of chemotherapy, with most due to a WW approach based on case note review. Patients with a delay in chemotherapy initiation are more likely to have a single organ site of metastatic disease and are older than those who do not. Despite the treatment delay, there is no evidence of a negative impact on survival.|
|Keywords:||Chemotherapy; colorectal; survival; watchful waiting|
|Rights:||© 2012 Blackwell Publishing Asia Pty Ltd.|
|Appears in Collections:||Medicine publications|
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