1. “small” T3 short-term RT and TME “large” T3 long-term CRT and TME T4 long term CRT and TME Therefore: tailored treatment

2. Stage III p < 0.001 10.6% 20.6%20.6% 10 20 3030 246 TME RT+TME

3. Stage III and CRM negative p < 0.001 6.0% 19.7%19.7% 10 20 3030 246 TME RT+TME

4. T1: TME alone T2 /T3: preoperative RT (5x5 Gy) +TME T3 threatened CRM: preoperative CRT+TME T4: preoperative CRT+TME Tailored treatment with MRI scanning

5. p = 0.98 246 66% TME 65% RT+TME 100 80 60 40 20 Peeters, in press Overall Survival Dutch trial

6. pre-op (n=674) postop (n=676) p 5 yr LR4.7%11.q%<0.001 5 yr DFS79.5%74.9%0.03 5 yr OS80.8%78.7%0.07 Sebag Montefiore, ASCO 2006 MRC CR07 survival

7. Overall survival Survival in 40 years: 60%