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Recently, some studies have shown that surgery alone may be sufficient for patients with T3 rectal cancer. This raises the question of whether nCRT is necessary for all patients with T3 rectal cancer. Therefore, this study compared the clinical outcomes of patients with MRI\u2010defined T3, clear MRF mid\u2013low rectal cancer treated with surgery alone (TME group) or nCRT followed by surgery (nCRT\u00a0+\u00a0TME group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 1509 patients were enrolled in this study. After a 1:1 propensity score matching analysis, 480 patients were included in each group. The primary endpoint was 3\u2010year disease\u2010free survival (DFS). The secondary endpoints included the perioperative outcomes, histopathologic outcomes, and other follow\u2010up outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      nCRT had advantages in rates of sphincter\u2010preserving surgery and tumor downstaging, but it was accompanied by a higher rate of enterostomies. At 3\u00a0years after surgery, local recurrence occurred in 3.3% of patients in the TME group and in 3.5% of patients in the nCRT\u00a0+\u00a0TME group (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.914), the DFS rates were 78.3% in the TME group and 75.3% in the nCRT\u00a0+\u00a0TME group (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.188), and the overall survival rates were 90.3% in the TME group and 89.9% in the nCRT\u00a0+\u00a0TME group (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.776).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Surgery alone versus nCRT followed by surgery may provide similar long\u2010term oncological outcomes for patients with MRI\u2010defined T3, clear MRF, and mid\u2013low rectal cancer. nCRT may cause overtreatment in some patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.16451","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:35:06Z","timestamp":1705365306000},"page":"858-867","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["MRI\u2010defined T3, clear mesorectal fascia mid\u2013low rectal cancer: is neoadjuvant treatment necessary?"],"prefix":"10.1111","volume":"39","author":[{"given":"Ziwei","family":"Zeng","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, The Sixth Affiliated Hospital Sun Yat\u2010sen University  Guangzhou Guangdong China"},{"name":"Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital Sun Yat\u2010sen University  Guangzhou Guangdong China"},{"name":"Department of Colorectal Surgery, Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital Sun Yat\u2010sen University  Guangzhou Guangdong China"},{"name":"University Clinic Mannheim, Medical Faculty Mannheim University of Heidelberg  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ze","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, The Sixth Affiliated Hospital Sun Yat\u2010sen University  Guangzhou Guangdong China"},{"name":"Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital Sun Yat\u2010sen University  Guangzhou Guangdong China"},{"name":"Department of Colorectal Surgery, Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital Sun Yat\u2010sen University  Guangzhou Guangdong 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