11. Neoadjuvant chemoradiotherapy stratification treatment recommendations for stage II−III rectal cancer.

Risk stratification for recurrence of stage II−III rectal cancer	Treatments	Recommended level
MRF, mesorectal fascia; EMVI, extramural vascular invasion; CRT, long-course concurrent chemoradiotherapy; TME, total mesorectal excision; SCRT, short-course radiotherapy.
Low-risk group, meeting all the following criteria	Direct TME surgery; Surgical quality evaluation of TME; Postoperative adjuvant therapy is determined by postoperative pathology; If high quality TME surgery is not assured, preoperative CRT + delayed surgery/SCRT + immediate surgery should be performed;	Recommended
≤cT3a/b
cN0−2 (no cancer deposits)
MRF (−)
The tumor is located in the posterior wall of the rectum;		Recommended
EMVI (−)
Middle-risk group, MRF (−) and meeting any or more of the following criteria	Preoperative CRT + delayed surgery/SCRT + immediate surgery	Recommended
cT3c/d
Extremely low lesion
cN1−2 cancer deposits
EMVI (+)
High-risk group, meeting one or more of the following criteria	Preoperative CRT + delayed surgery/SCRT sequential neoadjuvant chemotherapy + delayed surgery	Recommended
cT3 with MRF (+)
cT4
The elevator ani muscle is invaded; Lateral lymph node (+)
Elderly patients with infirmity or severe complications who cannot tolerate CRT	SCRT + delayed surgery	Recommended