“Organ preserving treatment in rectal cancer: patient selection –quality of life – costs”

Patients with locally extensive rectal cancer are treated with chemotherapy and radiation. 10-20% of these patients experience a clinically complete response after this treatment. These patients can be followed up  with a non-surgial treatment. We call this the watch-and-wait policy. In this thesis the focus is on selecting these patients, the quality of their life and the costs that this treatment entails.

- Patient selection: in patients who have an almost complete response, waiting longer can still lead to a complete response, without this having much influence on cancer outcomes.

- Quality of life: patients in the watch-and-wait were compared with patients undergoing surgery. It was found that the quality of life is better in almost all areas in the group of patients included in the watch-and-wait policy. Although surgery leads to more intestinal complaints, patients can certainly also suffer from intestinal complaints after chemotherapy and radiation.

- Costs: The average costs per patient in the watch-and-wait policy are € 6,713 and € 17,108 for the operated patients