Watch-and-wait management is viable for rectal cancers not palpable on exam, keeping patient outcomes comparable.

• 3-year local regrowth-free survival rates: 81.4% for palpable vs. 74.3% for nonpalpable tumors.
• 3-year disease-free survival rates: 80.8% for palpable vs. 74.3% for nonpalpable tumors.

Surgeons can confidently consider watch-and-wait for these cases without compromising efficacy.

• Initial clinical responses don’t significantly affect long-term outcomes, but delayed responses may indicate faster risks for recurrence and organ loss.