The watch-and-wait strategy versus radical resection for rectal cancer patients with a good response (≤ycT2) after neoadjuvant chemoradiotherapy

Purpose: This study aims to oncologic outcomes of the watch-and-wait (WW) strategy compared with radical resection (RR). Methods: Patients with rectal cancer who received neoadjuvant chemoradiotherapy (nCRT) and achieved ≤ycT2 between 2008 and 2016 were included. The mean follow-up time was 61 months (range, 0-168 months). Recurrence-free survival (RFS), local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS) were compared. A total of 446 patients were included, and WW was adopted for 34 patients. Results: 86.4%) demonstrated a statistically significant difference between the groups. Conclusion: By appointing the WW strategy, oncologic safety was not ensured. The WW strategy must be implemented with caution in patients with ≤ycT2 stage, particularly those with advanced initial cT stage.