Pathologic Complete Response and Survival Paradox in Locally Advanced Rectal Cancer

Pathologic complete response (PCR) after preoperative chemoradiation correlates with improved overall survival for locally advanced rectal cancer patients. While total neoadjuvant therapy (TNT) increases PCR rates, it does not improve overall survival. Patients achieving PCR after TNT have worse survival compared to those with chemoradiation alone. The route to achieving PCR may be a crucial factor in predicting oncologic outcomes, challenging the notion that PCR uniformly signifies better prognosis.