{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:08:43Z","timestamp":1791562123857,"version":"4.3.4"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Watch-and-wait (W&amp;amp;W) is an organ-preserving option for rectal cancer patients who achieve clinical complete response (cCR), but post-cCR outcomes after immunotherapy-containing neoadjuvant treatment in proficient mismatch repair (pMMR)\/microsatellite stable (MSS) locally advanced rectal cancer (LARC) remain unclear. We evaluated post-cCR oncological and organ-preservation outcomes in this selected population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective cohort study included patients with pMMR\/MSS LARC who achieved cCR after immunotherapy-containing neoadjuvant treatment at three medical centers and subsequently underwent W&amp;amp;W. Eligible patients had at least 12 months of post-cCR follow-up. Disease progression, survival, and organ-preservation outcomes were evaluated, and survival was estimated using the Kaplan\u2013Meier method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-five patients were included, with a median post-cCR follow-up of 26 months (range, 14\u201340 months). Three patients (12.0%) developed disease progression, including two with local regrowth and one with lung metastasis. Both local regrowths were treated with R0 salvage surgery. The estimated 2-year disease-free survival was 87.4% (95% CI, 65.7%\u201395.8%). Twenty-three patients (92.0%) avoided radical surgery, and 22 patients (88.0%) maintained disease-free organ preservation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This multicenter study provides preliminary real-world evidence on W&amp;amp;W after cCR in highly selected patients with pMMR\/MSS LARC treated with immunotherapy-containing neoadjuvant regimens, but larger prospective comparative studies with longer follow-up are required before its feasibility and oncological safety can be established.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1909441","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T05:30:11Z","timestamp":1786339811000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Watch-and-wait after immunotherapy-containing neoadjuvant treatment in pMMR\/MSS locally advanced rectal cancer: a multicenter real-world study"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhenkai","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Endoscopy, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renshen","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Oncology, Tianjin\u2019s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruihuan","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine and Clinical Research, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center","place":["Shanghai, China"]},{"name":"Department of Oncology, Shanghai Medical College, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2025.05.528","article-title":"Localised rectal cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up","volume":"36","author":"Hofheinz","year":"2025","journal-title":"Ann Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.24.01160","article-title":"Management of locally advanced rectal cancer: ASCO 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