[Discussion on treatment strategies for locally recurrent rectal cancer aiming at R0 resection and pathological complete response].

With the implementation of surgical techniques, such as total pelvic exenteration, and improvements in perioperative management, an increasing number of patients with locally recurrent rectal cancer (LRRC) are potential targets for curative surgery. Negative pathological margins (R0 resection) and favorable pathological complete response (pCR) have been identified as independent predictors of better oncological outcomes in LRRC. However, achieving R0 resection and optimal tumor regression remain primary concerns and significant challenges for colorectal surgeons. Based on the latest research both domestically and internationally, along with the clinical experience of authors' team, this article provides an overview to enhance the likelihood of achieving R0 resection and pCR from surgical strategies and perioperative therapies, aiming to offer a reference for colorectal surgeons specializing in locally recurrent rectal cancer.