Lower GI 2016

The Royal Marsden

The tumours that require preoperative therapy because of poor prognosis: • TME plane CRM involvement • Depth of extramural spread >5mm risk factor for poor DFS • Presence of MRI detected venous invasion – risk factor for local and distant recurrence and seen more frequently than path EMVI • MRI detected mucinous tumours • MRI Nodal involvement in the absence of any of the above does not confer any significant additional risk of either local or distant relapse