{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:12:50Z","timestamp":1792026770941,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>A complete or subcomplete tumour response (CTR) is observed in 10%\u201325% of patients with mid\/low rectal cancer after neoadjuvant chemoradiotherapy (CRT). The aim of our study was to report a multicentric French experience in local excision (LE) after CRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>All patients who underwent LE for mid\/low rectal cancer with suspected CTR after CRT, from 2006 to 2019 in seven GRECCAR centres were included. LE was considered adequate if the specimen showed a ypT0\/Tis\/T1R0 tumour, otherwise, a completion total mesorectal excision (TME) was discussed. Morbi\u2010mortality, functional results and oncological outcomes were studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 257 patients were included. LE specimens showed 36% ypT0, 4% ypTis and 19% ypT1. Thus, 108 patients (42%) had theoretical indication of completion TME, which was performed in only 42 patients. Overall, 30\u2010day morbidity after LE was 11%, including 2% Clavien\u2013Dindo grade III or IV complications. After completion TME, 47% described major low anterior resection syndrome versus 5% after LE alone (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). After a mean follow\u2010up of 4\u2009years (range 2\u20136\u2009years), the recurrence rate was 11% after LE, 32% after completion TME and 20% in patients for whom completion TME was indicated but not performed (<jats:italic>p<\/jats:italic>\u2009=\u20090.021).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TME remains the gold standard for mid\/low rectal cancer after CRT. LE in selected patients is safe for operative and functional, but also oncological, results. However, completion TME was indicated in 42% of patients after LE, highlighting the difficulty of the preoperative diagnosis of CTR after CRT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16742","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T04:32:24Z","timestamp":1694147544000},"page":"1973-1980","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Local excision after neoadjuvant chemoradiotherapy for mid and low rectal cancer: a multicentric French study from the <scp>GRECCAR<\/scp> group"],"prefix":"10.1111","volume":"25","author":[{"given":"M\u00e9lanie","family":"Calmels","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery DMU Digest, Beaujon Hospital, Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP), University of Paris\u2010Cit\u00e9  Clichy 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