What is your approach to cT3N0M0 mid rectal adenocarcinoma with clear circumferential resection margins on MRI?  

This is an important issue in management of rectal cancers. It is best handled with an informed discussion and decision by the patients considering the pros and cons of initial surgery versus neoadjuvant therapy. The problem is, of course, inaccuracy of pretreatment staging, with the false negative ...

These reflect real-life management dilemmas. Upstaging after primary resection is something we have all had to deal with. A multidisciplinary approach is essential.