Watch and wait (W&W) after neoadjuvant treatment of rectal cancer has been a focus in the field of rectal cancer in recent years. Many Chinese or international centers have accumulated valuable experience through conducting clinical research, but there are many disputes about the details of developing W&W, and there is also a problem of insufficient evidence level. Dozens of experts of gastrointestinal surgery, oncology, radiotherapy, pathology and radiology shared the experience of developing W&W and compiled the consensus on the W&W policy in rectal cancer patients after neoadjuvant treatment (2020). This article further analyzes and interprets 5 issues that are likely to cause confusion in consensus, including near-cCR and prolonged waiting time, the relationship between cCR and pCR, the role of biopsy in W&W, local resection, and contact X-ray brachytherapy, and at the same time explains the adjustments in the consensus based on national conditions.
直肠癌新辅助治疗后"等待观察"策略（W&W）是近年直肠癌领域的焦点问题，国内外各医疗中心通过开展临床研究，已积累了宝贵经验；但对于开展W&W的细节存在着诸多争议，也存在着证据级别不足的问题。数十位编审专家集思广益，分享了开展W&W的经验，共同编写了《直肠癌新辅助治疗后等待观察策略共识（2020版）》（《共识》）。本文就《共识》中易引起困惑的五个问题，即近临床完全缓解（near-cCR）与延长等待时间、临床完全缓解与病理学完全缓解的关系、活检在W&W中的作用、局部切除术以及接触性X线近距离治疗做进一步的分析和解读，同时阐述《共识》中根据国情做出的调整。.
Keywords: Clinical complete response; Neoadjuvant therapy; Rectal neoplasms; Watch and wait strategy.