Neoadjuvant Chemoradiotherapy Yields 84% 3-Year Survival for T4/N2 Rectal Cancer

Neoadjuvant chemoradiotherapy followed by total mesorectal excision resulted in a 3-year overall survival rate of 84% for patients with T4 and/or N2 rectal adenocarcinoma. Achieving R0 resection improved recurrence and survival rates, with T4 disease showing worse outcomes than N2. Adjuvant chemotherapy was associated with a survival benefit in the whole cohort and the N2 subgroup, but not in the T4 subgroup. Personalizing treatment strategies based on high-risk features could enhance outcomes in locally advanced rectal cancer.