Ruppert R, et al. - Researchers investigated a restrictive use of neoadjuvant chemoradiotherapy (nCRT) based on MRI findings for rectal cancer in this prospective multicentre observational study including patients with stage cT2–4 rectal cancer, with any cN and cM0 status. Patients with disease requiring nCRT exhibited higher 3- and 5-year rates of distant metastasis and worse disease-free survival compared to that of patients who did not need nCRT. Findings thereby suggest that restriction of nCRT to high-risk patients could achieve good results.