Management of complete response after neoadjuvant chemoradiotherapy in rectal cancer

Neoadjuvant chemoradiotherapy(CRT) followed by radical surgery including total mesorectal excision(TME) is standard treatment in patients with locally advanced rectal cancer. The benefits of neoadjuvant CRT have been well documented and include tumor regression and downstaging associated with increased tumor respectability, reduced local recurrence and a higher rate of sphincter preservation. Radical surgery for rectal cancer carries a high risk of morbidity and mortality and can also greatly detract from a patient's quality of life. In light of the significant response rates that can be achieved with preoperative CRT, some scholars have suggested limiting further surgical therapy to local excision alone or to observation for patients with clinical complete response(cCR). This article summarizes the latest development of management strategies for complete responders after neoadjuvant CRT for rectal cancer.