Organ preservation methods, like watch and wait, show high feasibility and safety in rectal cancer treatment.

• 26% of patients opted for organ preservation, predominantly through watch and wait (78%).
• 2-year overall survival rates exceeded 95% across all treatment strategies.
• No significant differences in oncologic outcomes between watch and wait and local excision were observed.

Surgeons can consider these approaches for nonmetastatic rectal cancer, as they support personalized treatment plans while maintaining strong survival metrics.