Li H, Wang H, Shao S, et al. - The standard treatment for locally advanced rectal cancer (LARC), currently, involves providing neoadjuvant chemoradiotherapy (nCRT) followed by surgery of total mesorectal excision (TME). For LARC patients, the potential prognostic factors, including the albumin-to-fibrinogen ratio (AFR), were investigated. The receiver operating characteristic (ROC) curve was used to determine the cut-off value of pretreatment AFR for overall survival (OS) in LARC patients (cT3-4 and/or cN1-2) who underwent nCRT followed by TME. Findings suggest a significant predictive value of AFR for OS with a cut-off value of 8.65 and an AUC of 0.882. In LARC patients, the pretreatment AFR level was identified to be the only independent risk factor for pathologic response to nCRT, 5-year OS and disease-free survival (DFS). Significant correlation of a low pretreatment AFR level with a poor 5-year OS and DFS was evident.