Treatments that have the potential to both cure rectal cancer and preserve the rectum may offer a considerable advantage over total mesorectal excision (TME), which provides excellent tumor control but often entails a permanent colostomy or a coloanal anastomosis. In this issue of JAMA Surgery, Stijns et al¹ report the results of a multicenter, nonrandomized feasibility study that investigated whether chemoradiotherapy followed by local excision (CRT-LE) is an oncologically acceptable rectum-preserving strategy for rectal cancer in stage cT1 3N0. Although the study was not powered to demonstrate the efficacy of CRT-LE compared with TME (which is the benchmark for any new treatment), it adds to the growing body of evidence supporting CRT-LE as an alternative to TME.

具有既可以治愈直肠癌又可以保护直肠的潜力的治疗方法可能会比全直肠系膜切除术（TME）具有可观的优势，后者可提供出色的肿瘤控制能力，但通常需要进行永久性结肠造口术或结肠直肠吻合术。在本期JAMA Surgery中，Stijns等人¹报道了一项多中心，非随机可行性研究的结果，该研究调查了放化疗后局部切除（CRT-LE）是否是cT1 3N0期直肠癌的肿瘤学上可接受的直肠保留策略。尽管该研究无力证明CRT-LE的疗效优于TME（这是任何新疗法的基准），但它增加了越来越多的证据支持CRT-LE替代TME。