{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:23:10Z","timestamp":1780500190208,"version":"3.54.1"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"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":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The standard treatment for early\u2010stage (cT2\u20103N0) rectal adenocarcinoma is upfront Total Mesorectal Excision (TME), but the desire for organ preservation has seen the increasing use of neoadjuvant therapy in these patients. Owing to its likely higher complete response rate, Total Neoadjuvant Therapy (TNT) is an attractive but understudied option. This study aimed to determine outcomes in patients with early\u2010stage rectal cancer undergoing TNT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective study of patients with cT2\u20103N0M0 rectal adenocarcinoma who underwent TNT instead of upfront surgery from 2019 to 2025 in South Australia. TNT comprised long\u2010course chemoradiotherapy followed by up to 8 cycles of FOLFOX or 6 cycles of CAPOX. Patients with cCR were offered watch and wait (W&amp;W) surveillance. The outcomes of interest included cCR rate, regrowth rate, local and distant recurrences (LR and DR) and 3\u2010year survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010nine patients were included, with mean tumour distance 4\u2009cm from the anal verge. The median follow\u2010up was 41\u2009months (IQR 26\u201361) and 53.8% had completed at least 3\u2009years of follow\u2010up. Thirty\u2010one patients (79.5%) achieved a cCR and proceeded to W&amp;W. The regrowth rate was 16.1%; none experienced a LR and three had a DR. The 3\u2010year DFS in the overall cohort was 94.1% (95% CI 86.3%\u2013100%) and all patients were alive up to 3\u2009years of follow\u2010up. The rate of Grade 3 or higher chemotherapy\u2010related toxicity was 25.6% and there were no deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients receiving TNT for early\u2010stage rectal cancer had a very high cCR rate and associated high organ preservation rate. This approach has potential quality of life advantages compared with surgery, with acceptable oncological and toxicity profiles.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70446","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T01:30:17Z","timestamp":1775266217000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Organ preservation with total neoadjuvant therapy in early\u2010stage rectal cancer: A statewide analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1398-3857","authenticated-orcid":false,"given":"Zachary","family":"Bunjo","sequence":"first","affiliation":[{"name":"Colorectal Unit, Department of Surgery Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Discipline of Surgery, Faculty of Health and Medical Sciences, School of Medicine Adelaide University  Adelaide South Australia 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