215 consecutive rectal cancer patients treated in six hospitals of the Łódź district between 1994 and 1998 were enrolled into this prospective study. We analyzed patients in whom local excision, low anterior resection, abdominoperineal resection and Hartmann's procedure were performed. 27 percent of patients received adjuvant therapy such as radio- or chemotherapy or both. Long-term results were compared between high and low volume institutions by means of local recurrence and five year survival rates.