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Currently, despite growing recognition of personalized medicine, systematic risk stratification and full incorporation of patient preferences for anal preservation and treatment tolerance remain challenging in some clinical settings. This review summarizes the latest clinical research progress on the watch\u2010and\u2010wait (W&amp;W) strategy for LARC, including the applicable population of W&amp;W, the factors predicting tumor regression, and the methods to increase the W&amp;W rate. 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