Surgeons should adapt to evolving treatment strategies for rectal cancer as consensus highlights critical approaches.

• Multidisciplinary evaluation is crucial for effective treatment and surgical outcomes.
• Total neoadjuvant therapy is now prioritized for high-risk tumors to improve organ preservation.

Consider integrating structured MRI reporting and surveillance strategies for non-operative management in patients showing clinical complete response.

• Biopsy protocols for near-complete responders have been clarified for improved decision-making.