Background Long-term survival for patients with cancer of the rectum (RC) is through the last 20 years dramatically improved from about 30% to 65% . Overall focus on disease with the creation of multidisciplinary teams, national quality databases certification of surgeons, etc. have contributed to the development especially in the last 10-15 years . The introduction of pre-operative Oncology, known as neoadjuvant treatment increased the survival rate by up to 10% in certain patient series. However, the prognosis remains poor for advanced cases, qua risk of metastasis and local cancer relapse.