OnCo
termsTerm

Organ preservation (watch-and-wait, bladder-sparing, larynx preservation)

aka organ-preservation, organ preservation, organ-sparing, organ sparing, bladder-sparing, bladder preservation, bladder-preserving, larynx preservation, larynx-preserving, sphincter preservation, sphincter-sparing, watch-and-wait, watch and wait, non-operative management, nonoperative management, NOM, rectum preservation, limb preservation, breast preservation, fertility-sparing, nerve-sparing

Curing a cancer with drugs and radiotherapy so that the organ (rectum, bladder, larynx, limb) does not have to be removed, keeping surgery in reserve for the minority whose cancer regrows.

Definitive chemoradiation preserves the larynx (VA Larynx trial) and the anus (Nigro); trimodality therapy preserves the bladder in selected muscle-invasive cancer and complete responders to enfortumab vedotin plus pembrolizumab are being spared cystectomy in trials; total neoadjuvant therapy with watch-and-wait for clinical complete responders preserves the rectum in about half of patients (OPRA), and dostarlimab alone cured dMMR rectal cancers without surgery or radiation. Requirements are reliable response assessment (MRI, endoscopy, ctDNA), intensive surveillance and the capacity for timely salvage surgery when regrowth occurs. Patients often accept some extra recurrence risk to keep their organ.

Category
Treatment jargon

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cancers

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Bladder & urothelial cancerColorectal cancerHead and neck squamous cell carcinoma

fronts

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Radiation TherapySurgery & Interventional

terms

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Active surveillance and observationChemoradiation (chemoradiotherapy, CRT)De-escalation, escalation and response-adapted therapyMuscle-invasive (MIBC) vs non-muscle-invasive (NMIBC) bladder cancerRadical cystectomySalvage therapyStoma (colostomy, ileostomy, urostomy)Total mesorectal excision (TME)Total neoadjuvant therapy (TNT, rectal cancer)