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Clinical Complete Response and Organ Preservation Strategies in Rectal Cancer: A Real-World Single-Center Experience Clinical Complete Response and Organ Preservation in Rectal Cancer

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dc.contributor.authorEncarnación, J.A.
dc.contributor.authorIbáñez, N.
dc.contributor.authorde la Fuente, I.
dc.contributor.authorGonzález, S.
dc.contributor.authorSánchez, M.
dc.contributor.authorBautista, Y.
dc.contributor.authorRodríguez, C.
dc.contributor.authorNadal, J.A.
dc.contributor.authorAbellán, I.
dc.contributor.authorMontoya, M.
dc.contributor.authorOno, A.
dc.contributor.authorCarbonell, G.
dc.contributor.authorFrutos, L.
dc.contributor.authorOrtiz, E.
dc.contributor.authorManso, C.
dc.contributor.authorRuiz Carreño, Paula
dc.contributor.authorMarín Vera, Miguel
dc.contributor.authorQuiles, B.
dc.contributor.authorAbrisqueta Carrión, Jesús
dc.contributor.authorRoyo-Villanova Reparaz, Carlota
dc.contributor.authorAlonso Romero, José Luis
dc.contributor.authorMarín-Zafra, G.
dc.contributor.authorGuirao, M.
dc.contributor.authorHernández, Q.
dc.contributor.departmentMedicina Interna
dc.contributor.otherFacultades de la UMU::Facultad de Medicina
dc.date.accessioned2026-03-25T09:34:09Z
dc.date.available2026-03-25T09:34:09Z
dc.date.copyright© 2026 by the authors
dc.date.issued2026-02-27
dc.description.abstractBackground: The management of rectal cancer has evolved toward response-adapted strategies, including organ preservation in selected patients achieving a clinical complete response (cCR) after neoadjuvant treatment. However, most available evidence derives from clinical trials, and data from real-world clinical practice remain limited. Methods: We conducted a retrospective observational cohort study including consecutive patients with rectal adenocarcinoma treated at a tertiary referral center between January 2021 and December 2025. Baseline clinical, tumor-related, and treatment characteristics were collected. Tumor response was assessed using clinical, endoscopic, and radiological criteria. The primary endpoint was the rate of clinical complete response and the implementation of watch-and-wait strategies. Secondary endpoints included recurrence patterns and exploratory oncologic outcomes according to baseline tumor characteristics. Results: A total of 229 patients were identified, of whom 148 were evaluable for treatment response. Clinical complete response was documented in 56 patients (37.8%), and a watch-and-wait strategy was implemented in 42 patients (28.4%). Higher cCR rates were observed in patients with stage I–II disease and in tumors measuring < 4 cm on baseline magnetic resonance imaging, with cCR rates exceeding 55% in this subgroup. Tumors ≥ 4 cm showed substantially lower response rates. Clinical complete responses were observed across both short-course radiotherapy plus chemotherapy and long-course chemoradiotherapy regimens in patients with small tumors and early-stage disease. Tumor distance from the anal verge was not consistently associated with response. With a median follow-up of 26 months in the watch-and-wait group, five recurrences were observed, including three local recurrences. Conclusions: In this real-world cohort, baseline tumor size and clinical stage were the main determinants of clinical complete response and eligibility for organ-preservation strategies in rectal cancer. Small tumors (<4 cm) showed high response rates regardless of neoadjuvant regimen. These findings support response-adapted, individualized treatment strategies and highlight the importance of tumor burden in selecting candidates for non-operative management in routine clinical practice.
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dc.identifier.citationEncarnación, J. A., Ibáñez, N., De la Fuente, I., Ruiz, P., González, S., Quiles, B., Sánchez, M., Bautista, Y., Rodríguez, C., Nadal, J. A., Marín, M., Marín-Zafra, G., Guirao, M., Hernández, Q., Abrisqueta, J., Abellán, I., Montoya, M., Ono, A., Carbonell, G., ... Alonso-Romero, J. L. (2026). Clinical Complete Response and Organ Preservation Strategies in Rectal Cancer: A Real-World Single-Center Experience Clinical Complete Response and Organ Preservation in Rectal Cancer. Cancers, 18(5), 763. https://doi.org/10.3390/cancers18050763
dc.identifier.doihttps://doi.org/10.3390/cancers18050763
dc.identifier.eissn2072-6694
dc.identifier.urihttp://hdl.handle.net/10201/222801
dc.languageeng
dc.publisherMDPI
dc.relationSin financiación externa a la Universidad
dc.relation.publisherversionhttps://www.mdpi.com/2072-6694/18/5/763
dc.rightsAttribution 4.0 International*
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectClinical complete response
dc.subjectWatch and wait
dc.subjectNeoadjuvant therapy
dc.subjectRectal cancer
dc.subjectOrgan preservation
dc.subjectRadiotherapy
dc.subjectTotal neoadjuvant therapy
dc.subjectReal-world evidence
dc.subject.odsObjetivo 3: Salud
dc.titleClinical Complete Response and Organ Preservation Strategies in Rectal Cancer: A Real-World Single-Center Experience Clinical Complete Response and Organ Preservation in Rectal Cancer
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dspace.entity.typePublicationes
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