Evidence map›Paper›PMID 42137461›Full record

ReviewOncology letters2026

Watch-and-wait in rectal cancer: A critical appraisal of promise, perils and unresolved contours of organ preservation (Review).

Xinqiang Zhu, Beibei Ge, Linchun Wen, Siwei Shan

Abstract readReview
In one paragraph

Review in Oncology letters, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Xinqiang ZhuDepartment of General Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, Jiangsu 223800, P.R. China.
Beibei GeDepartment of General Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, Jiangsu 223800, P.R. China.
Linchun WenDepartment of General Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, Jiangsu 223800, P.R. China.
Siwei ShanDepartment of General Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, Jiangsu 223800, P.R. China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Total neoadjuvant therapy has elevated pathological complete response (pCR) rates in locally advanced rectal cancer to unprecedented levels (25-30%), catalyzing interest in organ preservation via the non-surgical 'Watch-and -Wait' (WaW) strategy. Although this approach offers a paradigm shift, its rapid clinical adoption necessitates a critical appraisal of unresolved controversies. The present review synthesizes current evidence to outline the benefits of WaW while critically examining its inherent challenges. A comprehensive analysis interrogates the dualistic nature of WaW. It can provide favorable survival (5-year overall survival of 85% and cancer-specific survival of 94% in the International WaW Database) and meaningful quality-of-life improvements by avoiding radical surgery; concurrently, it embodies substantial risks due to the inherent imprecision of clinical complete response (cCR) assessment (a 10-25% discordance with pCR), a marked local regrowth rate (~25%) and unresolved long-term oncological uncertainties. In the present review it is argued that successful implementation of WaW depends on transcending current limitations through technological integration. Circulating tumor DNA is a promising but still investigational biomarker that may enable dynamic risk stratification; however, its clinical utility requires prospective validation. In conclusion, WaW has evolved from a radical concept to a reasonable, evidence-supported option within a precision oncology framework for a meticulously selected patient cohort, contingent upon rigorous multidisciplinary team assessment and an unwavering, structured surveillance protocol. Its future safety and efficacy will be defined by advances in response assessment, personalized monitoring and long-term outcome data.

Indexed as

circulating tumor DNAclinical complete responselocal regrowthorgan preservationrectal cancertotal neoadjuvant therapywatch-and-wait

Identifiers

PMID42137461
PMCPMC13169478

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.