Comment on Timing of Surgery For Patients With Rectal Cancers Not Responding to Preoperative Chemoradiation—Reply

In Reply We would like to thank our colleagues for their interesting considerations. Our analysis draws a picture of current clinical practice in rectal cancer by including all patients treated for rectal cancer in the period under consideration.¹ For this reason, we do not fully agree with the possible selection bias highlighted by Raj et al because no upfront selection was made to exclude advanced cancers. For clarity, clinical node status was defined as positive or negative, and only the pathologic staging distinguished between ypN1 and ypN2. We focused on a subgroup of patients who are known to have a poorer prognosis, ie, those with a poor response to preoperative chemoradiation.^2,3