The easy-to-use nomograms can predict LR, DM, and OS over a 5-year period after surgery. They may be used as decision support tools in future trials by using the three defined risk groups to select patients for postoperative chemotherapy and close follow-up (http://www.predictcancer.org).

Organ preservation constitutes a paradigm shift in the management of patients with rectal cancer. One of the main reasons for exploring organ preservation strategies is the potential to preserve anorectal function, thus avoiding the need for permanent colostomy and maintaining quality of life (QoL) 1 . Deteriorations in several parameters of bowel function -including urgency, frequency, incontinence and bowel movement clusteringcan occur with variable frequency in patients with rectal cancer who receive low anterior resection after neoadjuvant chemoradiotherapy (CRT). The number of clinical trials examining organ preservation strategies such as nonoperative management (NOM) or local excision (LE) only after CRT in patients with rectal cancer is progressively increasing 1 . Habr-Gama and colleagues were the first to implement a selective NOM approach in patients with resectable rectal cancers with a clinical complete response (cCR) following CRT 2 . Since this initial study,

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