The treatment of rectal cancer has significantly developed over the last few decades, the standard of care treatment for patients with locally advanced rectal cancer being the neoadjuvant chemoradiotherapy (nCRT). Nowadays, nCRT is usually followed by definitive surgery, with total mesorectal excision (TME) and adjuvant chemotherapy. Despite favorable outcomes and potential advantages, this treatment approach can result in significant toxicity. The watch-and-wait (WW) strategy is an alternative approach and has been accepted as an alternative treatment in patients with rectal cancer who have had a complete clinical response (cCR) after neoadjuvant therapy. However, there are several open questions and concerns about this strategy, including the methods of patient selection, criteria to accurately determine cCR, both clinical and radiological, optimal duration of neoadjuvant treatment, optimal follow-up strategies and future possible perspectives of this approach. The aim of this review is to summarize the current available data and evidence on the WW strategy and the proven benefits this approach may have in patients with rectal cancer.
Keywords: rectal cancer, watch-and-wait, neoadjuvant therapy.
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