What does this research mean for the field?

A watch-and-wait surveillance protocol for rectal cancer patients achieving clinical complete response after chemoradiotherapy yields a high sustained response rate (84%) and enables early detection of local regrowth with universally successful surgical salvage. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Evaluate the effectiveness and outcomes of the watch and wait strategy for rectal cancer after LCCRT.

April 13, 2026

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

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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Discussion

Authors

Ben Finlay

Emma Powell

A. Long

Journals

ANZ Journal of Surgery

Actions

Institutions

The University of Adelaide

Sir Charles Gairdner Hospital

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

Key Points

Abstract

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Discussion

Authors

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