Assessment and management of the complete clinical response of rectal cancer to chemoradiotherapy

Preoperative chemoradiotherapy is considered by many as the preferred treatment strategy for distal rectal cancer. The observation of complete tumour regression has led to the proposition of nonoperative management of selected patients with complete clinical response (cCR) following treatment. We present results for the treatment of distal rectal cancer during 1991-2005. We have outlined the issues concerning adequate tumour assessment, the definition of complete response, and the advantages and disadvantages of conservative or surgical resection in patients with clinical and radiological evidence of cCR.