Dr. Paty on Patients With Rectal Cancer Ineligible for "Watch and Wait"

Philip B. Paty, MD, surgeon, Memorial Sloan Kettering Cancer Center, discusses patients with rectal cancer who are ineligible for a "watch and wait" approach.

Important factors to consider are tumor characteristics and the appearance of the rectal wall in the lymph nodes, Paty says. Tumors must be in a complete state of regression, which can be determined via cross-sectional imaging.

Tumors that are more difficult to eradicate are bulkier and larger in size are usually not fit for a "watch and wait" approach. Intermediate- and smaller-size tumors will likely have a higher cure rate via non-operative management; because they are smaller in size, it is easier to assess their response to treatment.

Patients with a lot of disease in the mesentery are also not appropriate candidates for "watch and wait," Paty says.