What's your follow-up protocol for a near complete response (nCR) in rectal patients considering non-operative management (NOM)?

This is a question that comes up in our colorectal tumor board routinely. For patients with a near-complete response after the completion of TNT, we recommend repeating an MRI of the rectum and endoscopic exam ~8 weeks later. If there is still a lack of complete response, our formal recommendation i...

If the residual disease is confined to the rectum and less than 3 cm wide and less than 1 cm deep, then I would recommend local tx: contact therapy, or a full-thickness local excision.