Rectal cancer restaging after neoadjuvant chemoradiation: towards a down-staging system

It is our policy to submit the patients affected by rectal cancer, T3 and T4, independently from N, to a neoadjuvant treatment with 50 Grays and FOLFOX chemotherapy. Surgery follows after 4–5 weeks, and it is preceded by a restaging procedure. In order to classify the down-staging of rectal tumors, we have adopted a score system (Table 1), inspired to the current TNM classification and based on imaging criteria.