Abstract: Neoadjuvant chemoradiotherapy combined with total mesorectal excision have become standard management for locally advanced rectal cancer. Neoadjuvant chemoradiotherapy could develop significant tumor regression and downstaging to achieve chances of sphincter preservation leading to pathological complete response. But surgery accompanied with mortality， complications and dysfunction. Thus the non-operative treatment such as organ preservation and watch-and-wait strategy might lead a new way.

Key words: Rectal cancer, Neoadjuvant chemoradiotherapy, Clinical complete response, Non-operative management, Organic protection, Watch and wait