The Dutch Watch and Wait Registry includes 289 patients with a complete or near complete clinical response following chemoradiation for localized rectal cancer. In the first 24 months, 86% did not require total mesorectal excision (TME) and 80% not even a local excision. This quality of life analysis reports little variation in generally good quality of life over this time period. Of note, there was an apparent decrease in female-reported sexual health during follow-up. Importantly, those who ultimately required TME reported significantly worse quality-of-life on several subscales, underscoring the inherent value of achieving long term organ preservation. | Custers, JAMA Surg 2023