Lower cCR rates in cT4 rectal cancer after total neoadjuvant therapy.

Patients with cT4 tumors show significantly lower chances of achieving a complete clinical response (cCR) compared to those with cT3.

Surgeons should consider tumor stage when counseling patients on nonoperative management options post-TNT.

Regrowth rates were similar: 27% for cT3 vs. 17% for cT4 (p = 0.75), with 86.8% of cCR patients opting for organ preservation.

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