BACKGROUND: Current guidelines advocate that all @entity5 @entity1 with American Joint Committee on @entity5 should be subjected to neoadjuvant therapy. However, improvements in surgical technique have resulted in single-digit local recurrence rates with surgery only. METHODS: Operative, postoperative, and oncological outcomes of @entity1 with and without neoadjuvant therapy were compared between January 2002 and December 2013. For this purpose, all @entity1 resected with low anterior rectal resection (LAR) and @entity348 ( @entity348 ) who had or had not been irradiated were identified from the authors' prospectively maintained database. @entity1 who were excluded were those with high @entity5 or AJCC stage IV disease; in the surgery-only group, @entity1 with AJCC stage I disease or with pT4Nx @entity5 ; and in the irradiated @entity1 , @entity1 with ypT4Nx or cT4Nx @entity5 . RESULTS: Overall, 454 consecutive @entity1 were included. A total of 342 (75 %) @entity1 were irradiated and 112 (25 %) were not irradiated. Median follow-up for all @entity1 was 48 months. Among @entity1 with and without irradiation, pathological circumferential resection margin positivity rates (2.9 vs. 1.8 %, p = 0.5) were not different. At 5 years, in irradiated @entity1 compared with surgery-only @entity1 , the incidence of local recurrence was decreased (4.5 vs. 3.8 %, p = 0.5); however, @entity262 occurred more frequently (10 vs. 17.8 %, p = 0.2). Irradiation did not affect overall or disease-free survival (neoadjuvant treatment vs. surgery-only: 84.9 vs. 88.2 %, p = 0.9; 76 vs. 79.1 %, p = 0.8). CONCLUSIONS: The current study adds to the growing evidence that suggests a selective rather than generalized indication for neoadjuvant treatment in @entity5 .

Comparative Outcomes of Neoadjuvant Treatment Prior to Total Mesorectal Excision and Total Mesorectal Excision Alone in Selected Stage II/III Low and Mid XXXX .

@entity5 :: ('MESH:D009369', 'Disease') :: ['Cancer (AJCC) stages II and III disease', 'stages II and III rectal cancer', 'rectal cancer'] @entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity262 :: ('MESH:D034721', 'Disease') :: ['systemic recurrences'] @entity348 :: ('MESH:C535338', 'Disease') :: ['TME', 'total mesorectal excision']
@entity5 :: (MESH:D009369,Disease) :: ['Rectal Cancer']
