Neoadjuvant chemoradiation followed by surgery is standard of care for locally advanced rectal cancer.The impact of pathologic response remains unclear.We reviewed the impact of pathologic response on prognosis in patients with locally advanced rectalcarcinoma (cⅡ and cⅢ).We initially looked at the impact of complete pathologic response (pCR) defined as absence of cancer cells in the surgical specimen.We identified from our colorectal cancer database 242 patients with primary cⅡ and cⅢ rectal cancer staged by CT and ERUS/MRI who received 5FU-based chemoradiation followed by R0 surgery during 1997-2007.Median radiotherapy dose was 5040 cGy.We initially compared 58 patients (24%) with pCR to the remaining 184 patients.