Surveillance protocol - post TNT without surgery
Hi everyone,
Lately we have more patient have complete response after TNT treatment and has not require surgery. They have been put on wait and watch surveillance.
Would like to know what other health service been doing with there group of patients. My service has not build a proper surveillance protocol for wait and watch yet, we have take reference from other health service’s internal protocol - MRI and flexi-sig 3monthly alternate.
Love to hear what everyone been doing!
Created: 02 Mar 2026 04:03:16 PM
At Royal Hobart Hospital we have developed a guideline which encapsulates 3 schedules of surveillance: low risk (stage I/II with no neoadjuvant or adjuvant tx), high risk (stage II/III/IV with neoadjuvant or adjuvant tx) and watch and wait (rectal with complete response).
For our watch and wait - patients have flex sig/MRI pelvis/CTCAP OR PET 8 weeks post completion of TNT, then be discussed in our MDM for consensus of "clinical response" or "nil residual disease".
The surveillance schedule runs as follows: MRI 3 monthly for first year, 3 or 6 monthly in year 2 and 6 monthly in year 3 to 5. flexi sig 3 monthly for year 1 and 2. Then colonoscopy at year 3 and 5. CTCAP 6 monthly for years 1 and 2 then yearly for 3 to 5.
It's much easier to see in a table! Feel free to contact me via rhh.gisurveillancecnc@ths.tas.gov.au and I can send you a visual.
Hope this helps!