biostudies-literatureUnknown40(1)Cantagalli MMTo highlight the opportunities and pitfalls of organ-preservation strategies for rectal cancer and to define the clinical circumstances in which radical total mesorectal excision (TME) remains imperative, particularly when treatment is delivered outside referral centres. Two illustrative patients initially managed in a tertiary hospital that is not a referral centre for rectal cancer and organ-preservation strategies are presented. Clinical records, imaging, histopathology, and follow-up were reviewed. Key management decisions were compared with current European Society for Medical Oncology (ESMO) and Italian Association of Medical Oncology (AIOM) guidelines, as well as recent evidence from systematic reviews. Case 1 involved a bulky (10 cm), circumferential cT3N + mucinous adenocarcinoma.International journal of colorectal disease186https://www.ebi.ac.uk/biostudies/studies/S-EPMC12373536biostudies-literatureOrgan preservation in rectal cancer: opportunity within boundaries.PMC12373536Sani VCantagalli MMde'Angelis NSchena CAfalseOrgan preservation in rectal cancer: opportunity within boundaries.To highlight the opportunities and pitfalls of organ-preservation strategies for rectal cancer and to define the clinical circumstances in which radical total mesorectal excision (TME) remains imperative, particularly when treatment is delivered outside referral centres. Two illustrative patients initially managed in a tertiary hospital that is not a referral centre for rectal cancer and organ-preservation strategies are presented. Clinical records, imaging, histopathology, and follow-up were reviewed. Key management decisions were compared with current European Society for Medical Oncology (ESMO) and Italian Association of Medical Oncology (AIOM) guidelines, as well as recent evidence from systematic reviews. Case 1 involved a bulky (10 cm), circumferential cT3N + mucinous adenocarcinoma.2025-01-01T00:00:00Z2025 Aug2026-05-09T10:33:20.136Z2026-04-08T00:49:20.676ZS-EPMC123735364084701610.1007/s00384-025-04984-w