In Austria, patients with rectal cancer that has not spread to other parts of the body are typically treated with either total neoadjuvant therapy (TNT) or immunotherapy, depending on their microsatellite status (DNA repair capacity). However, treatment can vary considerably between hospitals in Austria. These differences may include the type and duration of treatment, as well as the active ingredients used. There are currently no clear recommendations on which exact treatment is best for each specific case. The aim of this observational study is to collect information on the different treatments used in Austria for patients with localized rectal cancer and to document the outcomes of these treatments. Only information and samples collected as part of the patients' routine care will be used for the study. Participation in the study will not change or affect the treatment chosen by the treating physician.
The purpose of this observational study is to establish a registry for locally advanced rectal adenocarcinoma. This registry will document the treatment regimens of participants receiving "total neoadjuvant therapy (TNT)" as well as those with dMMR/MSI-H disease. The ABCSG R07 Rectal Cancer Registry (RCR) study will provide real-world data that reflect the current therapeutic landscape for participants. Participants who are either treated with "total neoadjuvant therapy (TNT)" or those with dMMR/ MSI-H disease, as well as their response to the respective standard therapy, will be documented. "Total neoadjuvant therapy (TNT)" is the preferred treatment option for locally advanced rectal adenocarcinoma; however, treatment is carried out according to a different TNT protocol at each hospital or institute. Since the observational study does not interfere with the course of treatment, neither additional health risks nor any individual benefit from participation in the non-interventional study is to be expected. This study is being conducted at approx. 6 study sites in Austria, and a total of about 600 participants (retrospective and prospective) will take part. The treating physician selects the treatment/therapy that she/he considers most appropriate for the participant. In the retrospective part participants with localized, non-metastatic rectal cancer treated with total neoadjuvant therapy or participants with dMMR/MSI-H status irrespective of treatment between June 2020 (or June 2005 for dMMR/MSI-H cohort,) and start of this non-interventional study will be enrolled. In the prospective part participants with localized, non-metastatic rectal cancer treated with total neoadjuvant therapy or participants with dMMR/MSI-H status irrespective of treatment between start of this non-interventional study and three years thereafter will be enrolled.
Study Type
OBSERVATIONAL
Enrollment
600
LKH Salzburg-PMU, Univ. Klinik f. Innere Med III
Salzburg, State of Salzburg, Austria
Ordensklinikum Linz - BHS
Linz, Upper Austria, Austria
Kepler Universitätsklinikum Linz
Linz, Upper Austria, Austria
Treatment Responses (clinical standard therapy)
Recording of treatment responses according to clinical standard therapy.
Time frame: At the time of surgery
Proportion of different TNT concepts used
Treatment details
Time frame: From therapy start to Surgery
Proportion of participants using immunotherapy
Time frame: From therapy start to Surgery
Proportion of participants using watch & wait therapy
Time frame: At surgery visit
Proportion of the surgical techniques used
Time frame: At surgery
Proportion of locoregional recurrences
Time frame: From therapy start until 3 years from re-staging or end of primary treatment
Proportion of the participants with distant metastases
Time frame: From therapy start until 3 years from re-staging or end of primary treatment
Event-free survival (EFS)
EFS includes locoregional event, distant metastasis and death
Time frame: From therapy start until 3 years from re-staging or end of primary treatment
TME-free survival in watch & wait group
Time frame: From therapy start until 3 years from re-staging or end of primary treatment
Overall survival (OS)
Time frame: From therapy start until 3 years from re-staging or end of primary treatment
Locoregional event-free survival (LREFS)
locoregional progression, recurrence, regrowth or death
Time frame: From therapy start until 3 years from re-staging or end of primary treatment
Distant metastasis-free survival (DMFS)
Time frame: From therapy start until 3 years from re-staging or end of primary treatment
Charlson Comorbidity Index (CCI) Score prior to any treatment start
Time frame: Baseline
ECOG performance status at diagnosis
Time frame: Diagnosis
Proportion of resection rates
Time frame: Surgery
Treatment adherence
Time frame: From therapy start until surgery
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