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On longer follow\u2010up, an unexpected increased risk in local recurrence in the TNT group at the RAPIDO trial suggested early surgery for nonresponding tumours. The WW option is globally accepted for a complete clinical response; however, a high rate of regrowth was found in a registry with an increased risk of distant metastases, questioning the deleterious effect of deferral of surgery in this group. The short\u2010 and long\u2010term toxic effects of neoadjuvant treatment are costs to consider in the National Comprehensive Cancer Network guidelines compared with the European Society for Medical Oncology guidelines, which favour surgery alone if good mesorectal resection is assured with increasing surgical proficiency adjusted to the precise anatomical location.<\/jats:p>","DOI":"10.1111\/codi.16854","type":"journal-article","created":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T05:20:30Z","timestamp":1703913630000},"page":"383-385","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Rectal cancer \u2013 avoiding surgery?"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5057-3331","authenticated-orcid":false,"given":"Julio S.","family":"Leite","sequence":"first","affiliation":[{"name":"Department of Surgery Coimbra University Hospital  Coimbra 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