| Abstract: The watch and wait (W&W) strategy for patients achieving clinical complete remission (cCR) after neoadjuvant therapy (NAT) has been a hot issue in the field of rectal cancer in recent years. The W&W strategy not only achieves organ preservation but also reduces the psychological and economic burden of patients and improves their quality of life. The clinical decisions faced by surgeons at the stage of W&W treatment for rectal cancer patients have become particularly important. The aim of this article is to explore the clinical thinking of surgeons during this critical period, including the applicable population, monitoring follow-up, weighing potential risks and benefits, consideration of individual differences, and clinical study design of W&W strategies. The critical role of the surgeon in the decision-making process is emphasised. This review illustrates that future research should focus on optimising the implementation and evaluation of W&W strategies, while the collaboration of multidisciplinary teams, patient education, and integration of psychological support will provide a more comprehensive management plan for patients. The development of precision medicine will further promote individualised treatment strategies for optimal outcomes. The role of the surgeon will change from a surgical performer to a coordinator of treatment decisions, working closely with the multidisciplinary team to develop and execute treatment plans to achieve patient-centred treatment goals. |
