“…Previous studies reported that the tumor regression grade is associated with patient survival [7] and that pathologic complete responders have better oncologic outcomes [4,5,6]. Therefore, clinicians have tried to apply rectum-preserving treatment strategies such as transanal local excision (LE) or the wait-and-see approach for nCRT-receiving patients who responded well [8,9,10,11,12,13,14,15,16,17,18,19,20]. Many previous studies reported that LE after nCRT showed oncologic outcomes similar to that of radical surgery [8,9,10,11,12,13,14,15]; however, no definite conclusions have been derived to date because of the limitations of retrospective study designs.…”