Survey results of US radiation oncology providers’ contextual engagement of watch-and-wait beliefs after a complete clinical response to chemoradiation in patients with local rectal cancer

Jehan Yahya, Daniel Herzig, Matthew Farrell, Catherine Degnin, Yiyi Chen, John Holland, Simon Brown, Christina Binder, Jerry Jaboin, Vassiliki Tsikitis, Nima Nabavizadeh, Charles Thomas, Timur Mitin

Research output: Contribution to journalArticle

Abstract

Background: Watchful waiting in rectal cancer patients with a complete clinical response (cCR) to chemoradiation therapy (CRT) forgo upfront resection has been proposed. Growing evidence suggests that a watch-and-wait approach using resection for salvage of local recurrence may improve quality of life without jeopardizing outcomes. The current acceptance of watch-and-wait by US radiation oncologists (ROs) is unknown. Methods: US ROs completed our IRB-approved anonymous e-survey regarding non-surgical management of patients who achieved a cCR to neoadjuvant CRT. Self-ranked knowledge of the OnCoRe Project—UK prospective observational study of watch-and-wait—was tested for its association with ROs’ attitudes using the Chi-squared or Fisher’s test, as indicated. Supporters of observation are self-identified. Results: of the 220 respondents, 48% (n=106) of respondents support watchful waiting and 48% claimed familiarity with the OnCoRe Project. Respondents supporting observation were more likely to be familiar with the publication (P=0.029). Among watch-and-wait supporters, 59% (n=62) felt comfortable discussing this approach and 41% preferred the conversation be initiated by other specialists. There was no association between comfort level in discussing watch-and-wait and familiarity with the OnCoRe Project. ROs treating more than 10 locally advanced rectal cancer (LARC) patients annually felt more comfortable discussing watch-and-wait (P=0.015) compared to ROs seeing fewer patients. Conclusions: Almost half of surveyed US ROs support watch-and-wait, though many do not feel comfortable discussing this paradigm with patients. Knowledge of the OnCoRe Project is associated with support of watch-and-wait, yet not comfort level in leading the discussion. These results inform provider attitudes toward future clinical study participation.

Original languageEnglish (US)
Pages (from-to)1127-1132
Number of pages6
JournalJournal of Gastrointestinal Oncology
Volume9
Issue number6
DOIs
StatePublished - Dec 1 2018

Fingerprint

Radiation Oncology
Rectal Neoplasms
Watchful Waiting
Observation
Neoadjuvant Therapy
Research Ethics Committees
Observational Studies
Publications
Surveys and Questionnaires
Radiation Oncologists
Quality of Life
Prospective Studies
Recurrence

Keywords

  • Multidisciplinary
  • Non-surgical management
  • Radiotherapy
  • Rectal neoplasm
  • Total mesorectal excision (TME)

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

@article{a6b03c7f64344ef7bf8172964e8c8261,
title = "Survey results of US radiation oncology providers’ contextual engagement of watch-and-wait beliefs after a complete clinical response to chemoradiation in patients with local rectal cancer",
abstract = "Background: Watchful waiting in rectal cancer patients with a complete clinical response (cCR) to chemoradiation therapy (CRT) forgo upfront resection has been proposed. Growing evidence suggests that a watch-and-wait approach using resection for salvage of local recurrence may improve quality of life without jeopardizing outcomes. The current acceptance of watch-and-wait by US radiation oncologists (ROs) is unknown. Methods: US ROs completed our IRB-approved anonymous e-survey regarding non-surgical management of patients who achieved a cCR to neoadjuvant CRT. Self-ranked knowledge of the OnCoRe Project—UK prospective observational study of watch-and-wait—was tested for its association with ROs’ attitudes using the Chi-squared or Fisher’s test, as indicated. Supporters of observation are self-identified. Results: of the 220 respondents, 48{\%} (n=106) of respondents support watchful waiting and 48{\%} claimed familiarity with the OnCoRe Project. Respondents supporting observation were more likely to be familiar with the publication (P=0.029). Among watch-and-wait supporters, 59{\%} (n=62) felt comfortable discussing this approach and 41{\%} preferred the conversation be initiated by other specialists. There was no association between comfort level in discussing watch-and-wait and familiarity with the OnCoRe Project. ROs treating more than 10 locally advanced rectal cancer (LARC) patients annually felt more comfortable discussing watch-and-wait (P=0.015) compared to ROs seeing fewer patients. Conclusions: Almost half of surveyed US ROs support watch-and-wait, though many do not feel comfortable discussing this paradigm with patients. Knowledge of the OnCoRe Project is associated with support of watch-and-wait, yet not comfort level in leading the discussion. These results inform provider attitudes toward future clinical study participation.",
keywords = "Multidisciplinary, Non-surgical management, Radiotherapy, Rectal neoplasm, Total mesorectal excision (TME)",
author = "Jehan Yahya and Daniel Herzig and Matthew Farrell and Catherine Degnin and Yiyi Chen and John Holland and Simon Brown and Christina Binder and Jerry Jaboin and Vassiliki Tsikitis and Nima Nabavizadeh and Charles Thomas and Timur Mitin",
year = "2018",
month = "12",
day = "1",
doi = "10.21037/jgo.2018.08.02",
language = "English (US)",
volume = "9",
pages = "1127--1132",
journal = "Journal of Gastrointestinal Oncology",
issn = "2078-6891",
publisher = "Pioneer Bioscience Publishing Company (PBPC)",
number = "6",

}

TY - JOUR

T1 - Survey results of US radiation oncology providers’ contextual engagement of watch-and-wait beliefs after a complete clinical response to chemoradiation in patients with local rectal cancer

AU - Yahya, Jehan

AU - Herzig, Daniel

AU - Farrell, Matthew

AU - Degnin, Catherine

AU - Chen, Yiyi

AU - Holland, John

AU - Brown, Simon

AU - Binder, Christina

AU - Jaboin, Jerry

AU - Tsikitis, Vassiliki

AU - Nabavizadeh, Nima

AU - Thomas, Charles

AU - Mitin, Timur

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: Watchful waiting in rectal cancer patients with a complete clinical response (cCR) to chemoradiation therapy (CRT) forgo upfront resection has been proposed. Growing evidence suggests that a watch-and-wait approach using resection for salvage of local recurrence may improve quality of life without jeopardizing outcomes. The current acceptance of watch-and-wait by US radiation oncologists (ROs) is unknown. Methods: US ROs completed our IRB-approved anonymous e-survey regarding non-surgical management of patients who achieved a cCR to neoadjuvant CRT. Self-ranked knowledge of the OnCoRe Project—UK prospective observational study of watch-and-wait—was tested for its association with ROs’ attitudes using the Chi-squared or Fisher’s test, as indicated. Supporters of observation are self-identified. Results: of the 220 respondents, 48% (n=106) of respondents support watchful waiting and 48% claimed familiarity with the OnCoRe Project. Respondents supporting observation were more likely to be familiar with the publication (P=0.029). Among watch-and-wait supporters, 59% (n=62) felt comfortable discussing this approach and 41% preferred the conversation be initiated by other specialists. There was no association between comfort level in discussing watch-and-wait and familiarity with the OnCoRe Project. ROs treating more than 10 locally advanced rectal cancer (LARC) patients annually felt more comfortable discussing watch-and-wait (P=0.015) compared to ROs seeing fewer patients. Conclusions: Almost half of surveyed US ROs support watch-and-wait, though many do not feel comfortable discussing this paradigm with patients. Knowledge of the OnCoRe Project is associated with support of watch-and-wait, yet not comfort level in leading the discussion. These results inform provider attitudes toward future clinical study participation.

AB - Background: Watchful waiting in rectal cancer patients with a complete clinical response (cCR) to chemoradiation therapy (CRT) forgo upfront resection has been proposed. Growing evidence suggests that a watch-and-wait approach using resection for salvage of local recurrence may improve quality of life without jeopardizing outcomes. The current acceptance of watch-and-wait by US radiation oncologists (ROs) is unknown. Methods: US ROs completed our IRB-approved anonymous e-survey regarding non-surgical management of patients who achieved a cCR to neoadjuvant CRT. Self-ranked knowledge of the OnCoRe Project—UK prospective observational study of watch-and-wait—was tested for its association with ROs’ attitudes using the Chi-squared or Fisher’s test, as indicated. Supporters of observation are self-identified. Results: of the 220 respondents, 48% (n=106) of respondents support watchful waiting and 48% claimed familiarity with the OnCoRe Project. Respondents supporting observation were more likely to be familiar with the publication (P=0.029). Among watch-and-wait supporters, 59% (n=62) felt comfortable discussing this approach and 41% preferred the conversation be initiated by other specialists. There was no association between comfort level in discussing watch-and-wait and familiarity with the OnCoRe Project. ROs treating more than 10 locally advanced rectal cancer (LARC) patients annually felt more comfortable discussing watch-and-wait (P=0.015) compared to ROs seeing fewer patients. Conclusions: Almost half of surveyed US ROs support watch-and-wait, though many do not feel comfortable discussing this paradigm with patients. Knowledge of the OnCoRe Project is associated with support of watch-and-wait, yet not comfort level in leading the discussion. These results inform provider attitudes toward future clinical study participation.

KW - Multidisciplinary

KW - Non-surgical management

KW - Radiotherapy

KW - Rectal neoplasm

KW - Total mesorectal excision (TME)

UR - http://www.scopus.com/inward/record.url?scp=85058184122&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058184122&partnerID=8YFLogxK

U2 - 10.21037/jgo.2018.08.02

DO - 10.21037/jgo.2018.08.02

M3 - Article

VL - 9

SP - 1127

EP - 1132

JO - Journal of Gastrointestinal Oncology

JF - Journal of Gastrointestinal Oncology

SN - 2078-6891

IS - 6

ER -