[Comment] Evolution in rectal cancer management

Non-operative management after a clinical complete response following neoadjuvant treatment in rectal cancer, often referred to as opportunistic non-operative management rather than intentional non-operative management (ie, up-front treatment for early-stage patients with the aim of non-operative management), is increasingly being implemented. Provided meticulous follow-up, data suggest that non-operative management is feasible, safe, and associated with favourable overall survival.1 However, challenges remain, such as response assessment after neoadjuvant therapy,2 management of near clinical complete response,3 and whether distant control is affected.