Total neoadjuvant therapy increases risk of breached mesorectal excision but reduces disease progression in rectal cancer

Total neoadjuvant therapy for rectal cancer is associated with higher rates of breached total mesorectal excision compared to standard long-course chemoradiation, but no significant differences in surgical mortality or major complications. However, it significantly lowers the risk of disease progression to an unresectable stage during neoadjuvant treatment. Further research is needed to identify patients who will benefit from this approach.