The landscape of immunotherapy for locally advanced rectal cancer (LARC) has evolved rapidly in recent years [1], offering new possibilities for patients to consider the watch-and-wait strategy, which may reduce the risk of unnecessary perioperative complications [2]. However, the decision to avoid the standard surgery and adopt the watch-and-wait strategy necessitates a reliable preoperative method for determining the pathological complete response (pCR; ypT0N0) status.