Local Regrowth in Rectal Cancer After Watch-and-Wait Strategy Signals Higher Distant Metastasis Odds Than Upfront Surgery

A retrospective multicenter study compared the risk of distant metastases in rectal cancer patients who achieved a clinical complete response followed by local regrowth with those managed by surgery after chemoradiation. Out of 79 patients with local regrowth, 21 developed distant metastases, whereas only 10 out of 74 patients in the upfront surgery group had distant metastases. Local regrowth and final pathology were identified as independent risk factors associated with distant metastases. The study highlights the higher risk of distant metastases in patients with local regrowth after watch-and-wait therapy.