Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Karmakar R, Kandalkar A, Mukundan A. Total neoadjuvant therapy in rectal cancer: Challenging traditions without compromising surgical safety. World J Gastrointest Oncol 2026; 18(2): 115507 [PMID: 41695933 DOI: 10.4251/wjgo.v18.i2.115507]
World J Gastrointest Oncol. Feb 15, 2026; 18(2): 115507 Published online Feb 15, 2026. doi: 10.4251/wjgo.v18.i2.115507
Total neoadjuvant therapy in rectal cancer: Challenging traditions without compromising surgical safety
Riya Karmakar, Aditya Kandalkar, Arvind Mukundan
Riya Karmakar, Arvind Mukundan, School of Engineering and Technology, Sanjivani University, Kopargaon 423603, Maharashtra, India
Aditya Kandalkar, Department of Information Technology, Sanjivani College of Engineering, Kopargaon 423603, Maharashtra, India
Co-first authors: Riya Karmakar and Aditya Kandalkar.
Author contributions: Karmakar R and Kandalkar A contribute equally to this study as co-first authors; Karmakar R, Kandalkar A and Mukundan A conceptualized and designed the research, performed data curation, developed the methodology and performed writing-review and editing; Mukundan A performed formal analysis, acquired the funding for this research and supervised the research; Kandalkar A wrote the original draft; Karmakar R and Kandalkar A carried out investigation, conducted project administration, provided resources and were responsible for software.
Conflict-of-interest statement: The authors declare no conflict of interest.
Corresponding author: Arvind Mukundan, PhD, Assistant Professor, Postdoctoral Fellow, School of Engineering and Technology, Sanjivani University, Sanjivani Factory, Singnapur, Kopargaon 423603, Maharashtra, India. arvindmukund96@gmail.com
Received: October 20, 2025 Revised: November 12, 2025 Accepted: December 5, 2025 Published online: February 15, 2026 Processing time: 108 Days and 12.7 Hours
Core Tip
Core Tip: Total neoadjuvant therapy (TNT) signifies an advancing standard in the treatment of locally advanced rectal cancer, incorporating systemic chemotherapy prior to surgery and radiotherapy. Recent research, including the Rectal Cancer and Preoperative Induction therapy followed by Dedicated Operation based TNT regimen evaluated by Jabbar et al, indicates comparable oncologic safety, comparable oncologic safety and promising postoperative quality-of-life improvements. This editorial synthesizes known data on TNT’s effectiveness, tolerability, and promise for organ preservation, while highlighting ongoing discussions about treatment sequencing, fibrosis risk, and long-term results. The discussion highlights the significance of meticulous patient selection and multidisciplinary supervision in enhancing rectal cancer treatment via personalized, patient-focused multimodal therapy.
