[Local regrowth: what are the surgical options?]

The different treatment concepts for rectal cancer are in a continuous state of change and were recently summarized and presented in the updated German S3 guidelines. While organ preservation is of increasing importance in the clinical routine, modern multimodal total neoadjuvant treatment strategies can achieve complete and nearly complete response rates of up to 50%. For these patients this subsequently means the necessity for close monitoring models in a watch-and-wait concept, whereby various studies have now shown local recurrence rates of25-30% within the first 2 years. Due to increasing implementation of effective total neoadjuvant treatment concepts and the accompanying increasing incidence of local recurrence after initial complete response, the question of the optimal treatment regimen in these situations increasingly arises. This article summarizes the current evidence in this context and presents an interdisciplinary treatment algorithm.