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新辅助治疗在直肠癌中得到了广泛运用，其可缩小肿瘤体积，降低肿瘤分期，改善患者预后，是局部进展期直肠癌患者术前的标准治疗方法。新辅助治疗对于直肠癌患者的治疗效果存在显著个体差异，其肿瘤退缩结果差别明显，部分肿瘤退缩良好的患者甚至达到病理完全缓解。肿瘤退缩结果对于手术方式的选择和远切缘的确定具有重要意义，但目前关于肿瘤退缩模式的研究较少，且新辅助治疗后远切缘安全距离也存在较大争议。因此，本文结合目前研究进展，对直肠癌新辅助治疗后肿瘤主要退缩模式进行总结，将其分为肿瘤收缩、肿瘤碎片化和黏液湖形成这三种；对肿瘤大体退缩和镜下退缩进行对比，描述两者退缩不同步的现象；对临床完全缓解患者非手术治疗的安全性进行分析，阐述手术治疗必要性；对手术安全切除范围进行研究，探讨远切缘安全距离。

Neoadjuvant therapy has been widely applied in the treatment of rectal cancer, which can shrink tumor size, lower tumor staging and improve the prognosis. It has been the standard preoperative treatment for patients with locally advanced rectal cancer. The efficacy of neoadjuvant therapy for rectal cancer patients varies between individuals, and the results of tumor regression are obviously different. Some patients with good tumor regression even achieve pathological complete response (pCR). Tumor regression is of great significance for the selection of surgical regimes and the determination of distal resection margin. However, few studies focus on tumor regression patterns. Controversies on the safe distance of distal resection margin after neoadjuvant treatment still exist. Therefore, based on the current research progress, this review summarized the main tumor regression patterns after neoadjuvant therapy for rectal cancer, and classified them into three types: tumor shrinkage, tumor fragmentation, and mucin pool formation. And macroscopic regression and microscopic regression of tumors were compared to describe the phenomenon of non-synchronous regression. Then, the safety of non-surgical treatment for patients with clinical complete response (cCR) was analyzed to elaborate the necessity of surgical treatment. Finally, the review studied the safe surgical resection range to explore the safe distance of distal resection margin.