{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T02:37:33Z","timestamp":1781663853812,"version":"3.54.5"},"reference-count":24,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"KWF Dutch Cancer Society research grant"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Rectal cancer patients with a clinical complete response to neoadjuvant (chemo)radiation are eligible for Watch and Wait (W&amp;W). For local regrowth, total mesorectal excision (TME) is considered the standard of care. This study evaluated local excision (LE) for suspected local regrowth. From 591 patients prospectively entered into a national W&amp;W registry, 77 patients with LE for regrowth were included. Outcomes analyzed included histopathologic findings, locoregional recurrence, long-term organ preservation, and colostomy-free and overall survival. In total, 27\/77 patients underwent early LE (&lt;6 months after neoadjuvant radiotherapy) and 50\/77 underwent late LE (\u22656 months). Median follow-up was 53 (39\u201369) months. In 28\/77 patients the LE specimen was histopathologically classified as ypT0 (including 9 adenomas); 11\/77 were ypT1, and 38\/77 were ypT2\u20133. After LE, 13\/77 patients with ypT2\u20133 and\/or irradical resection underwent completion TME. Subsequently, 14\/64 patients without completion TME developed locoregional recurrence, and were successfully treated with salvage TME. Another 8\/77 patients developed distant metastases. At 5 years, overall organ preservation was 63%, colostomy-free survival was 68%, and overall survival was 96%. There were no differences in outcomes between early or late LE. In W&amp;W for rectal cancer, LE can be considered as an alternative to TME for suspected regrowth in selected patients who wish to preserve their rectum or avoid colostomy in distal rectal cancer.<\/jats:p>","DOI":"10.3390\/cancers14133071","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T01:59:47Z","timestamp":1655949587000},"page":"3071","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Role of Local Excision for Suspected Regrowth in a Watch and Wait Strategy for Rectal Cancer"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4318-6688","authenticated-orcid":false,"given":"Barbara M.","family":"Geubels","sequence":"first","affiliation":[{"name":"Department of Surgery, Netherlands Cancer Institute\u2014Antoni van Leeuwenhoek, Postbox 90203, 1006 BE Amsterdam, The Netherlands"},{"name":"Department of Surgery, Catharina Hospital, Postbox 1350, 5602 ZA Eindhoven, The Netherlands"},{"name":"GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1348-7973","authenticated-orcid":false,"given":"Vincent M.","family":"Meyer","sequence":"additional","affiliation":[{"name":"GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands"},{"name":"Department of Surgery, University Medical Centre Groningen, Postbox 30.001, 9700 RB Groningen, The Netherlands"},{"name":"Department of Surgery, Isala Hospitals, Postbox 10400, 8000 GK Zwolle, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1910-2723","authenticated-orcid":false,"given":"Henderik L.","family":"van Westreenen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Isala Hospitals, Postbox 10400, 8000 GK Zwolle, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1671-9912","authenticated-orcid":false,"given":"Geerard L.","family":"Beets","sequence":"additional","affiliation":[{"name":"Department of Surgery, Catharina Hospital, Postbox 1350, 5602 ZA Eindhoven, The Netherlands"},{"name":"GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brechtje A.","family":"Grotenhuis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Catharina Hospital, Postbox 1350, 5602 ZA Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Dutch Watch and Wait Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2537","DOI":"10.1016\/S0140-6736(18)31078-X","article-title":"Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): An international multicentre registry study","volume":"391","author":"Hilling","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1245\/s10434-017-6213-8","article-title":"Organ Preservation in Rectal Cancer After Chemoradiation: Should We Extend the Observation Period in Patients with a Clinical Near-Complete Response?","volume":"25","author":"Hupkens","year":"2018","journal-title":"Ann. 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