Development and Assessment of a Clinical Calculator for Estimating the Likelihood of Recurrence and Survival Among Patients With Locally Advanced Rectal Cancer Treated With Chemotherapy, Radiotherapy, and Surgery

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Abstract
The adoption of multimodal therapy for locally advanced (tumor categories 3-4 or node categories 1-2) rectal cancer, including preoperative chemotherapy and radiotherapy, has produced improvements in cancer outcomes.1-3 Tumor regression facilitates margin-negative resection and is associated with lower rates of local recurrence.1 The range of tumor response to neoadjuvant therapy varies,4 and patients with complete clinical response (ie, no radiographic or endoscopic evidence of tumor) may be candidates for observation without surgery, often referred to as watch-and-wait or nonoperative management.5,6 Most patients have a less-than-complete response, and the extent of tumor downsizing and downstaging is prognostic.4

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