What is the watch and wait strategy in the treatment of lower rectal cancer?

Surgery following neo-adjuvant chemoradiotherapy has been the standard in the treatment of lower rectal cancer for some time, providing good oncological outcomes. However, for patients who achieve a clinical complete response, in addition to surgery, the concept of a watch-and-wait (W&W) strategy, has been developed, that is, simply monitoring these patients with no surgical intervention. The W&W strategy can ensure a significantly higher organ preservation rate but with similar oncological outcomes as in patients after total mesorectal excision. Thus, the W&W strategy is considered an attractive treatment choice to avoid major surgery and permanent stoma, in patients with lower rectal cancers. It is also a valid treatment strategy for patients who are willing to accept potentially worse oncological outcomes to achieve this goal.