Current literature regarding LRRC has been predominated by reported outcomes of surgical salvage with curative intent. In these highly selected patients, a survival advantages has been demonstrated after margin-negative resection, with reported 5-year overall survival (OS) rates of 9–43%. [3, 9] However, significant trade-offs exist. Peri-operative morbidity and mortality are substantial; bowel, urinary and sexual functions as well as life style can be permanently altered; and prolonged multi-dimensional rehabilitation is needed after hospital discharge.