Watch and Wait in Patients with Clinical Complete Response After Neoadjuvant Therapy with Rectal Cancer: Is it Safe?

The treatment of locally advanced rectal cancer has been transformed over the last century with nearly 40% of patients achieving complete eradication of their tumor with total neoadjuvant therapy alone. Nonoperative management with a watch-and-wait approach has now allowed a subset of patients the chance to avoid surgery altogether with 50% of watch-and-wait patients achieving long-term organ preservation. However, the other half of patients develop either local regrowth, which requires expeditious surgical intervention, or distant recurrence. Watch-and-wait is a reasonable option for select patients in a protocolized environment that can successfully deliver the recommended surveillance protocol, which ensures its safety.