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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2025; 17(9): 107831
Published online Sep 27, 2025. doi: 10.4240/wjgs.v17.i9.107831
Published online Sep 27, 2025. doi: 10.4240/wjgs.v17.i9.107831
Watch and wait in locally advanced rectal cancer: Evolution, current evidence, and future directions
Andrés García-Fernández, Pilar del Pozo-Elso, Arantxa Villadóniga-Sánchez, Department of General Surgery, Virgen de la Luz Hospital, Cuenca 16002, Castille-La Mancha, Spain
Raquel Martínez, Miguel Suárez, Department of Gastroenterology, Virgen de la Luz Hospital, Cuenca 16002, Castille-La Mancha, Spain
Raquel Martínez, Miguel Suárez, Medical Analysis Expert Group, Universidad de Castilla-La Mancha, Cuenca 16071, Castille-La Mancha, Spain
Raquel Martínez, Miguel Suárez, Medical Analysis Expert Group, Instituto de Investigación Sanitaria de Castilla-La Mancha, Toledo 45071, Castille-La Mancha, Spain
Co-first authors: Andrés García-Fernández and Pilar del Pozo-Elso.
Author contributions: García-Fernández A decided the design and structure of the manuscript; García-Fernández A, del Pozo-Elso P, and Villadóniga-Sánchez A contributed to the writing and elaboration of the table; All authors contributed to the review of the literature, and approved the final version of the manuscript to publish. García-Fernández A and del Pozo-Elso P contributed equally as co-first authors.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
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: Andrés García-Fernández, MD, Department of General Surgery, Virgen de la Luz Hospital, Calle Hermandad de Donantes de Sangre, 1, Cuenca 16002, Castille-La Mancha, Spain. angarciafernandez@sescam.jccm.es
Received: March 31, 2025
Revised: May 11, 2025
Accepted: July 11, 2025
Published online: September 27, 2025
Processing time: 179 Days and 14.6 Hours
Revised: May 11, 2025
Accepted: July 11, 2025
Published online: September 27, 2025
Processing time: 179 Days and 14.6 Hours
Core Tip
Core Tip: The management of locally advanced rectal cancer has undergone major advancements, shifting toward more personalized and less invasive strategies. This review explores key innovations, including the watch and wait approach for clinical complete responders, the total neoadjuvant therapy paradigm, and the expansion of minimally invasive surgical techniques. Additionally, targeted therapies and immunotherapy are emerging as promising options. These advancements aim to improve survival while preserving organ function and minimizing morbidity. Future research should focus on optimizing patient selection and long-term outcomes, ensuring that novel therapeutic strategies continue to enhance cancer care.