The positive outcome of IRMT plus capecitabine was shown in ypCR rates ranging from 14.1% to 30.6% with grade 3 rates from 11.1% to 17.6% 28,26, but these reports did not mention PD cases. Lu et al. 29 only reported a ypCR of 20% with grade 3 at 22%, and PD in 17% of cases. Reports of controlled trials also did not mention PD. Thus, it is likely that PD cases were missed in these studies. Consequently, good local control outcomes did not correlate with good survival in patients. The timing of surgery after chemoradiation must be reconsidered in the future.