{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:24:34Z","timestamp":1792758274251,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this work was to apply the \u2018win ratio\u2019 to compare the outcomes of rectal\u2010sparing approaches [watch and wait (WW) and local excision (LE)] in the management of locally advanced rectal cancer responding to neoadjuvant chemoradiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Patients enrolled in the ReSARCh study (NCT02710812) between 2016 and 2021 were divided into two cohorts (WW vs. LE). The win ratio was calculated by dividing the number of successes (or wins) in the WW group by the number of successes in the LE group on matched pairs. Oncological outcomes (overall survival, distant and local recurrence), presence of a stoma and rectum not preserved were considered as outcomes of interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 108 (62.1%) patients underwent LE and 66 (37.9%) WW. Patients who underwent WW were more likely to have a complete clinical response (cCR) at restaging [i.e. ycT\u2009=\u20090:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200951 (80%) for WW vs.\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200945 (42%) for LE,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001]. After matching for age, sex, distance from the anal verge and T stage at restaging, i.e. ycT, 57 pairs of patients were identified. The overall win ratio considering only oncological outcomes was 0.4 (95% CI 0.02\u20130.94). The disadvantage of WW was mainly due to a higher rate of local recurrences. The overall win ratio considering oncological outcomes, presence of a stoma and rectum not preserved was 0.6 (95% CI 0.04\u20131.38), indicating a potential disadvantage for WW, but with wide confidence intervals suggesting uncertainty.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LE may have an advantage in terms of local recurrence rates compared with WW, potentially conferring a survival benefit. These results should be confirmed in further prospective randomized trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70077","type":"journal-article","created":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T19:47:32Z","timestamp":1743277652000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparing local excision with watch and wait for the management of rectal cancer patients responding to neoadjuvant chemoradiotherapy: Composite endpoint analysis using the win ratio"],"prefix":"10.1111","volume":"27","author":[{"given":"Giulia","family":"Capelli","sequence":"first","affiliation":[{"name":"Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG) University of Padova  Padova Italy"},{"name":"Department of Surgery ASST Bergamo Est  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Lorenzoni","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences University of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Vittoria","family":"Chiaruttini","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences University of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Delrio","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgical Oncology Istituto Nazionale Tumori \u2013 IRCCS Fondazione G. Pascale  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Guerrieri","sequence":"additional","affiliation":[{"name":"Surgery Clinic Polytechnic University  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Ortenzi","sequence":"additional","affiliation":[{"name":"Surgery Clinic Polytechnic University  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Cillara","sequence":"additional","affiliation":[{"name":"Department of Surgery Santissima Trinit\u00e0 Hospital  Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Restivo","sequence":"additional","affiliation":[{"name":"Department of Surgical Science University of Cagliari  Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Deidda","sequence":"additional","affiliation":[{"name":"Department of Surgical Science University of Cagliari  Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1493-1768","authenticated-orcid":false,"given":"Antonino","family":"Spinelli","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery, Department of Biomedical Sciences, Humanitas Clinical and Research Centre Humanitas University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmela","family":"Romano","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgical Oncology Istituto Nazionale Tumori \u2013 IRCCS Fondazione G. Pascale  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Bianco","sequence":"additional","affiliation":[{"name":"Department of Abdominal Oncology Istituto Nazionale Tumori \u2013 IRCCS Fondazione G. Pascale  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Sarzo","sequence":"additional","affiliation":[{"name":"Department of Surgery Sant' Antonio Hospital  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0238-0428","authenticated-orcid":false,"given":"Dajana","family":"Glavas","sequence":"additional","affiliation":[{"name":"Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG) University of Padova  Padova Italy"},{"name":"Department of Surgery Hospital of Camposampiero  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Morpurgo","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital of Camposampiero  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Belluco","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology CRO Aviano National Cancer Institute IRCCS  Aviano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Palazzari","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology CRO Aviano National Cancer Institute IRCCS  Aviano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuditta","family":"Chiloiro","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Fondazione Policlinico Universitario A. 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