BACKGROUND: Choosing the most effective approach for treating @entity5 with mesorectal fascia (MRF) involvement or closeness and synchronous distant metastases is a current clinical challenge. The aim of this retrospective study was to determine if upfront systemic chemotherapy and short-course radiotherapy (RT) with delayed surgery enables R0 resection. METHODS: Between March 2009 and October 2009, six @entity1 were selected for upfront chemotherapy and short-course RT (5   5 Gy) with delayed surgery. The @entity1 had locally advanced @entity5 with MRF involvement or closeness, as well as synchronous and potentially resectable distant metastases. Chemotherapy was administered to five @entity1 between the end of the RT and surgery. All @entity1 underwent @entity348 ( @entity348 ). RESULTS: The median @entity1 age was 54 years (range 39-63). All primary and metastatic lesions were resected simultaneously. The median duration between short-course RT and surgery was 13 weeks (range, 7-18). R0 resection of rectal lesions was achieved in 5 @entity1 . One @entity1 , who had a very low-lying @entity5 , had an R1 resection. The median follow-up duration for all @entity1 was 16.7 months (range, 15.5-23.5). One @entity1 developed liver @entity3 at 15.7 months. There have been no local recurrences or @entity204 . CONCLUSIONS: Upfront chemotherapy and short course RT with delayed surgery is a valuable alternative treatment approach for @entity1 with MRF involvement or closeness of @entity5 with distant metastases.

Upfront systemic chemotherapy and preoperative short-course radiotherapy with delayed surgery for locally advanced XXXX with distant metastases.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'primary tumors', 'rectal cancer'] @entity348 :: ('MESH:C535338', 'Disease') :: ['TME', 'total mesorectal excision'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis'] @entity204 :: ('MESH:D003643', 'Disease') :: ['deaths']
@entity5 :: (MESH:D009369,Disease) :: ['rectal cancer']
