"Wait-and-see": a new treatment strategy for rectal cancer with complete response after neoadjuvant chemoradiotherapy
Undoubtedly, the treatment strategies for patients with rectal cancer especially for those with locally advanced rectal cancer (LARC) have changed dramatically. Neoadjuvant chemoradiotherapy (NCRT) combined with total mesorectal excision (TME) has been regarded as the gold standard treatment for LARC. NCRT can not only reduce tumor volume, downstage tumor grade and increase sphincter preservation rate, but also allow some patients to achieve a clinical even pathologic complete response. However, the radical surgery may cause great surgical trauma, multiple complications and lifelong suffering of permanent colostomy. So, whether radical surgery can be avoided by instead applying non-surgical “wait-and-see” approach in patients with complete response has become a top-level strategic issue for colorectal surgeons in recent years. Here, the authors address the definition, characteristics, evolution and research status of the “wait-and-see” strategy with some considerations for future prospects of this new strategy.