This study, conducted by the Dutch Colorectal Cancer Group, aimed to determine whether preoperative radiotherapy combined with total mesorectal excision (TME) improves local control in patients with resectable rectal cancer. The trial involved 1861 patients randomly assigned to either preoperative radiotherapy followed by TME (924 patients) or TME alone (937 patients). The overall survival rates at two years were similar between the two groups (82.0% vs. 81.8%). However, the rate of local recurrence was significantly lower in the preoperative radiotherapy group (2.4%) compared to the surgery-only group (8.2%). The study concluded that short-term preoperative radiotherapy, when combined with standardized TME, reduces the risk of local recurrence in patients with rectal cancer.This study, conducted by the Dutch Colorectal Cancer Group, aimed to determine whether preoperative radiotherapy combined with total mesorectal excision (TME) improves local control in patients with resectable rectal cancer. The trial involved 1861 patients randomly assigned to either preoperative radiotherapy followed by TME (924 patients) or TME alone (937 patients). The overall survival rates at two years were similar between the two groups (82.0% vs. 81.8%). However, the rate of local recurrence was significantly lower in the preoperative radiotherapy group (2.4%) compared to the surgery-only group (8.2%). The study concluded that short-term preoperative radiotherapy, when combined with standardized TME, reduces the risk of local recurrence in patients with rectal cancer.