RENO: A Longitudinal Cohort Study of ‘Watch and Wait’ in Complete Clinical Responders after Chemo-radiotherapy for Localised Rectal Cancer (REctal cancer Non-Operative)

The current treatment approach for patients with rectal cancer involves neoadjuvant chemoradiation followed by surgical resection. The surgery can lead to complications and long-term consequences. Complete response is observed in approximately 40% of cases after chemoradiation followed by combination chemotherapy (TNT – total neoadjuvant therapy approach). A number of recent studies have shown that patients can be observed safely after completing chemoradiation without surgery, provided an apparent complete response has been achieved.  Resection is reserved for recurrent cancer cases. This approach potentially avoids unnecessary surgical resection and the resulting complications in this group of patients. This study will investigate the non-operative management approach prospectively.

The aim of RENO is to determine the rate of local failure and organ preservation in patients with rectal cancer who have achieved a complete clinical response after Neo-Adjuvant treatment and are then managed by ‘wait and watch’ strategy.