Recent trends in locally advanced rectal cancer treatment have focused on risk-stratification of patients and tailoring treatment to achieve the best outcome while limiting the impact on long-term quality of life.
There has been increasing interest in watch-and-wait approaches to achieve organ preservation. This article provides an overview of some major developments in the multimodal treatment of locally advanced rectal cancer, reviews controversial issues of the watch-and-wait approach and opportunities to personally tailor and reduce treatment, and provides an algorithm example of how such a personalized, tailored, adaptive, and reduced treatment could look like in the future.