Local excision in rectal cancer: When and for whom?

Local excision (LE) is an effective treatment option for rectal cancer that shows significant regression following neoadjuvant chemoradiotherapy. Compared to traditional total mesorectal excision (TME), LE can achieve comparable oncological outcomes while preserving function and improving quality of life (QoL). The indications for LE have been gradually expanded, but there are uncertainties regarding postoperative oncological results. Long-term follow-up prospective randomized controlled trials comparing TME and LE in terms of both oncological outcomes and QoL could help reduce uncertainties between these two approaches and contribute to the development of evidence-based guidelines for rectal cancer treatment.