关键词: 局部进展期直肠癌, 完全缓解, 等待观察, 器官保留, 新辅助治疗

Abstract: For rectal cancer patients with clinical complete response (cCR ) and/or near-CCR (ncCR) after neoadjuvant chemoradiotherapy, their clinical treatment strategies have always been controversial, including total mesorectal excision (TME) surgery, local excision, or a “watch & wait (W&W)” approach. TME surgery brings related risks while non-surgical treatment strategies not only preserve the organ (Organ preservation, OP) and improve patients’ life quality but also promisingly achieve oncological safety similar to TME. The “W&W” strategy avoids unnecessary surgical trauma and the risk of severe complications. With the continuous improvement of the complete response rate of neoadjuvant therapy, the importance of the “W&W” strategy in the comprehensive treatment of rectal cancer is bound to be further enhanced. Optimizing neoadjuvant therapy strategies, accurately identifying people who will get benefits, enhancing the precision of complete response assessment, and refining follow-up monitoring and salvage treatment schemes are crucial for ensuring the safety of organ-preserving oncology. It is noteworthy that blindly initiating a W&W approach carries the potential risks of local recurrence and compromised prognosis; therefore, it is recommended to conduct this in clinical centers with extensive experience in the comprehensive treatment of rectal cancer, and strengthen patient-physician communication, to improve compliance with follow-up, and safeguard the treatment outcomes.

Key words: locally advanced rectal cancer, complete response, watch and wait, organ preservation, neoadjuvant therapy