Local excision of scars after a complete clinical response to neoadjuvant CRT in rectal cancer—organ-preservation without function-preservation?

Management of rectal cancer has changed significantly over the last few decades (1). First, appropriateness of surgical technique with standardization of total mesorectal excision led to a substantial decrease in local recurrence rates (2). Second, the role of neoadjuvant chemoradiotherapy (nCRT) in further decreasing local failures after TME is currently well established (3). Finally, with optimal local disease control, the concept of organ-preservation has become an attractive alternative to patients with significant primary tumor regression after nCRT.