Positive and negative consequences of neoadjuvant treatment Neoadjuvant treatment followed by TME involve a high percentage of side effects associated with surgical complications both early and late, the toxicity associated with radiation or chemotherapy and alteration of bowel function, sexual, fecal continence and thus the quality of life (QoL). Among the advantages of neoadjuvant therapy, particularly the treatment associated CRT, it is notable that in 15-20% of cases have the disappearance of the primary tumor, or a pathologic complete response (pCR). Also lengthening the interval between pRT and/or CT and surgery is associated with an increased rate of pCR, therefore, unlike traditional 4-6 week intervals between the end of neoadjuvant therapy and surgery, currently there is tendency to perform surgery after 8-10 weeks, or even after 12 weeks. In patients with a pCR after neoadjuvant therapy, it have been showed a better outcome in long term than those who have a residual disease.