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Copyright ©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Feb 15, 2026; 18(2): 115507
Published online Feb 15, 2026. doi: 10.4251/wjgo.v18.i2.115507
Total neoadjuvant therapy in rectal cancer: Challenging traditions without compromising surgical safety
Riya Karmakar, Aditya Kandalkar, Arvind Mukundan
Riya Karmakar, Arvind Mukundan, School of Engineering and Technology, Sanjivani University, Kopargaon 423603, Maharashtra, India
Aditya Kandalkar, Department of Information Technology, Sanjivani College of Engineering, Kopargaon 423603, Maharashtra, India
Co-first authors: Riya Karmakar and Aditya Kandalkar.
Author contributions: Karmakar R and Kandalkar A contribute equally to this study as co-first authors; Karmakar R, Kandalkar A and Mukundan A conceptualized and designed the research, performed data curation, developed the methodology and performed writing-review and editing; Mukundan A performed formal analysis, acquired the funding for this research and supervised the research; Kandalkar A wrote the original draft; Karmakar R and Kandalkar A carried out investigation, conducted project administration, provided resources and were responsible for software.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arvind Mukundan, PhD, Assistant Professor, Postdoctoral Fellow, School of Engineering and Technology, Sanjivani University, Sanjivani Factory, Singnapur, Kopargaon 423603, Maharashtra, India. arvindmukund96@gmail.com
Received: October 20, 2025
Revised: November 12, 2025
Accepted: December 5, 2025
Published online: February 15, 2026
Processing time: 108 Days and 8.4 Hours
Core Tip

Core Tip: Total neoadjuvant therapy (TNT) signifies an advancing standard in the treatment of locally advanced rectal cancer, incorporating systemic chemotherapy prior to surgery and radiotherapy. Recent research, including the Rectal Cancer and Preoperative Induction therapy followed by Dedicated Operation based TNT regimen evaluated by Jabbar et al, indicates comparable oncologic safety, comparable oncologic safety and promising postoperative quality-of-life improvements. This editorial synthesizes known data on TNT’s effectiveness, tolerability, and promise for organ preservation, while highlighting ongoing discussions about treatment sequencing, fibrosis risk, and long-term results. The discussion highlights the significance of meticulous patient selection and multidisciplinary supervision in enhancing rectal cancer treatment via personalized, patient-focused multimodal therapy.