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We investigated the effect of a long interval before surgery after SCR in patients with resectable rectal cancer.Thirty-five patients with high risk rectal cancer receivedpre-operative SCR. Surgery was planned 4/6 weeks after completion of radiotherapy. The response to radiation therapy was measured by tumour regression grade on the surgical specimens.Pre-treatment staging was as follow: 13 T3Nx, 16 T3N0, 4 T3N1, 2 T2N0. The mean distance from the anal verge was 6 cm. The mean interval between SCR and surgery was 44 days. An AR was performed in 29 patients and an APR in 6. Post-operative complications occurred in 16 patients. Two patients (5.7%) died post-operatively. Downsizing occurred in all cases; downstaging in 28 (80%). TRG was as follows: 3 TRG1, 7 TRG2, 11 TRG3, 12 TRG4, 2 TRG5. At a median follow-up of 31 months three patients had died of their disease, six were alive with disease, 24 were alive and disease free.The long interval after SCR downsizes rectal cancer. Complete response is rare. TRG12 scores seem increasing with an interval larger than 6 weeks.