{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T19:55:38Z","timestamp":1785614138076,"version":"3.56.0"},"reference-count":101,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T00:00:00Z","timestamp":1742947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute of Health","award":["T32TR004418"],"award-info":[{"award-number":["T32TR004418"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The management of locally advanced rectal cancer has evolved significantly, shaped by advances in multimodal neoadjuvant therapy and a growing emphasis on organ preservation through the watch-and-wait approach. These advancements, however, introduce complex treatment decisions that require careful consideration by both patients and clinicians. Methods: This narrative review explores the evolution of the management of locally advanced rectal cancer and the role of shared decision-making in guiding treatment decisions, particularly for patients facing decisions between surgical resection and watch-and-wait. Additionally, it discusses the development of tools to aid in shared-decision making, current challenges in implementing shared decision-making and future directions for improvement patient centered care in locally advanced rectal cancer management. Results: Considerations for decision making include anatomical considerations that influence surgical options, the potential benefits and risks of watch-and-wait versus surgical resection of the rectum, and the impact of treatment on bowel, urinary, and sexual function. Additionally, patients must weigh the long-term implications of their choices on quality of life. Conclusions: Shared decision-making has emerged as a critical component of patient-centered care and ensures that treatment decisions align with patients\u2019 values and priorities. Given the preference-sensitive nature of the management of locally advanced rectal cancer, shared decision-making plays an important role in helping patients navigate these decisions.<\/jats:p>","DOI":"10.3390\/jcm14072255","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T12:20:01Z","timestamp":1742991601000},"page":"2255","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Shared Decision Making in the Treatment of Rectal Cancer"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5579-5152","authenticated-orcid":false,"given":"Jonathan S.","family":"Abelson","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Lahey Hospital and Medical Center, Burlington, MA 01805, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9990-552X","authenticated-orcid":false,"given":"Racquel S.","family":"Gaetani","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Lahey Hospital and Medical Center, Burlington, MA 01805, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander T.","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Section of Colorectal Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1378\/chest.11-0516","article-title":"A Brief Historical and Theoretical Perspective on Patient Autonomy and Medical Decision Making: Part II: The Autonomy Model","volume":"139","author":"Will","year":"2011","journal-title":"Chest"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Matlock, D.D., Jackson, L.R., Sandhu, A., and Scherer, L.D. 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