TME vs TME+nCT in Low-risk LARC
Comparative analysis of the clinical efficacy between primary Total Mesorectal Excision (TME) surgery and neoadjuvant chemotherapy combined with TME surgery for low-risk locally advanced rectal cancer. Randomly enrolling eligible patients into either the control group receiving neoadjuvant chemotherapy combined with TME surgery or the experimental group receiving primary TME surgery, and subsequently comparing the clinical outcomes of the two groups
• Newly diagnosed patients, aged 18 to 75 years;
• Pathologically confirmed rectal adenocarcinoma;
• Distance of the lower margin of the rectal tumor lesion from the anal margin \<15cm;
• High-resolution MRI indicates low-risk locally advanced rectal cancer: T1-3bN1-2 or T3aN0 or T3bN0; no involvement of the anal sphincter; negative mesorectal fascia (MRF) status; negative extramural vascular invasion (EMVI); no cancer nodules;
• Exclusion of patients with non-local recurrence or distant metastases;
• Absence of synchronous colorectal multiple primary cancers;
• Adequate physical condition to tolerate surgery and neoadjuvant chemotherapy, including cardiac, pulmonary, hepatic, and renal functions;
• The study physician assessed no difficulty in sphincter preservation;
• patients and their families will be willing to participate in this study and provide written informed consent.