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The optimal time for surgery after neoadjuvant chemoradiation (CR) is controversial.The effect of the time interval between CR and surgery on the result of treatment was assessed.From 2006, 108 pts with T2-4 N0-2 M0 rectal carcinoma were enrolled in the study. CR was given concurrently with 5-FU 350 mg/m2 and cisplatin 90 mg up to a total dose of 47 Gy. Surgery was performed after 21-40 days (group 1) and after 41-72 days (group 2) after CR.The distance of the ‘lower border of the tumour from the anal verge (5.1 ± 2.2 and 5 ± 2.3 cm) and theproportion of sphincter savingprocedure (SSP) (72.7% and 71.7%) were similar in both groups. There was a greater degree of tumour downstaging (pT0-2) in group 2 (52.8%) compared with group 1 (32.6%), P = 0.02. The tumour regression grade (grades 1-2) 39.6% and 29.1%, accordingly. At a median follow-up of 17 months there were 18.1% distant metastases (in 3.6% cases with local recurrence) in group 1 and 1.9% in group 2 (P = 0.008). Disease Free Survival (DFS) was 67.9% and 97.4% in groups 1 and 2 (P = 0.007). Overall survival (OS) was also better in group 2 (100%) comparing with group 1 (82.9%) (P = 0.02).Delaying surgery after CR did not increase the rate of SSP but it wasassociated with tumour downstaging and improved long term results.