{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T05:40:49Z","timestamp":1776750049832,"version":"3.51.2"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"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:p>The management of early\u2010stage rectal cancer continues to evolve, with increasing emphasis on organ preservation and treatment personalisation. Full thickness local excision (LE) is commonly employed in cT1N0 cancer as a relatively low\u2010morbidity method to risk stratify patients as having low\u2010risk pT1 disease, high\u2010risk pT1 disease or pT2+ disease depending on depth of invasion as well as other features such as lymphovascular invasion and tumour budding. This risk stratification as part of a \u2018two\u2010stage\u2019 approach helps guide whether surveillance is safe or completion therapy is required. However, the morbidity of LE is frequently overlooked, including its impact on definitive completion therapy. In this article, we summarise the current role of LE in early rectal cancer and highlight concerns surrounding the morbidity and oncological risks of full thickness LE. We conclude with a proposed contemporary algorithm for managing early\u2010stage rectal cancer that is patient\u2010centred but optimises for oncological safety.<\/jats:p>","DOI":"10.1111\/codi.70459","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:35:59Z","timestamp":1776674159000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cautious reappraisal of full thickness local excision in early\u2010stage rectal cancer: When less is not more"],"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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