A study in the Chinese Journal of Oncology suggests that radical surgery is the primary treatment for patients in pathologic complete remission (pCR) after neoadjuvant therapy for rectal cancer. Local excision or clinical observation alone requires great caution and is currently only suitable for patients with physical conditions that do not tolerate radical surgery or have a strong desire to preserve anus, refuse radical surgery, and perform in clinical trials. Researchers from the Department of Colorectal II, Division of Abdominal Surgery and Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China, retrospectively analyzed the clinical data of 52 patients with locally advanced intermediate and low rectal cancer who reached pCR of the primary tumor after neoadjuvant therapy. The preoperative clinical stages of patients included 10 cases of stage II (cT3-4N0) and 42 cases of stage III (cT3-4N+). After neoadjuvant treatment, clinical complete remission (cCR) was achieved in 10 cases (19%). The results showed that 51 patients underwent radical surgery, of which 5 (10%) had pathologically confirmed metastatic cancer still visible in the lymph nodes; 1 cCR patient underwent transanal local excision. The incidence of postoperative complications was 21% in the whole group of patients. The median follow-up time was 24 months, and only one patient developed bone metastasis and one patient had imaging findings of mesenteric and retroperitoneal lymph node enlargement during the follow-up period; there were no cases of tumor-specific death. The 2-year disease-free survival rate and overall survival rate of the whole group of patients were 96% and 100%, respectively.