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April 13, 2026ANZ Journal of Surgery1 citations

Seven Years of Watch and Wait With Rectal Cancer—Reflections and Optimisations

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BFBen FinlayEPEmma PowellALA. Long

Key Points

  • Evaluate the effectiveness and outcomes of the watch and wait strategy for rectal cancer after LCCRT.
  • Assessment of clinical and pathological responses in patients after lateral chemoradiation therapy (LCCRT) at SCGH.
  • Monitoring surveillance protocol for early detection of local regrowth.
  • Analysis of surgical outcomes related to complete clinical response (cCR) and pathological complete response (pCR).
  • 24% of patients achieved complete clinical response (cCR) after treatment, with 84% sustaining this response.
  • 16% of watch and wait patients showed signs of local regrowth during surveillance.
  • 20% of patients experienced pathological complete response (pCR) during surgery despite not achieving cCR.

Abstract

A total of 24% of patients referred for LCCRT at SCGH achieved cCR, and this was sustained in 84%. Sixteen percent of W&W patients had suspected local regrowth. Our surveillance protocol detected regrowth early, and surgical salvage was always possible. Twenty percent of patients undergoing surgery having pCR despite not having cCR highlights the difficulty of avoiding TME in all patients who have a pCR but suggests optimisations of our practice are possible. We propose a reduction in the length and intensity of our current protocol.

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Cite This Study

Finlay et al. (2026) studied this question.

synapsesocial.com/papers/69dc88f43afacbeac03eaa95https://doi.org/10.1111/ans.70672
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Long term outcome of patients with rectal cancer with complete clinical response or near complete clinical response after neoadjuvant therapy: A multicenter registry study by Chinese Watch and Wait Database.2024
  2. 2Potential Cure of Rectal Cancer after Neoadjuvant Concurrent Chemoradiotherapy with Clinical Complete Response after Local Treatment2026
  3. 3FP2.1 - The accuracy of radiological staging in rectal cancer patients post-long course chemoradiotherapy treatment2024
  4. 4Non-operative management of locally advanced rectal cancer with an emphasis on outcomes and quality of life: a narrative review2025 · 2 citations
  5. 5Organ preservation in rectal cancer following clinical complete response after short-course radiotherapy-based total neoadjuvant therapy2026