[A Case Report of Achieving cCR in Advanced Lower Rectal Cancer through TNT after Stoma Construction and Subsequent Stoma Closure].

To improve the prognosis of lower rectal cancer, our department has implemented total neoadjuvant therapy(TNT), which involves the preoperative administration of chemoradiotherapy combined with systemic chemotherapy. For patients who achieve a clinical complete response(cCR)with TNT, we offer the Watch-and-Wait(W & W)strategy as a treatment option. This approach allows for organ preservation and avoids immediate surgery, provided there is informed consent and strict follow-up. This report presents the case of a 61-year-old male with locally advanced lower rectal cancer who required stoma construction before treatment initiation. The cancer had invaded the prostate and levator ani muscles with lateral lymph node metastasis, causing the patient to experience severe anal pain. TNTs were performed after ileostomy. Post-treatment evaluation revealed cCR, and the patient was subsequently placed under the W & W strategy with strict follow-up. Two years after treatment, stoma closure was performed without recurrence and no significant defecation disorder was observed. Two years and 10 months have passed since treatment, and there are no signs of recurrence or maintenance of cCR.