Renz P, et al. - Researchers analyzed results in metastatic rectal adenocarcinoma patients with primary tumor resection with and without pelvic radiotherapy using the National Cancer Database (NCDB). From 2004 to 2014, they asked the NCDB for patients with stage IV rectal adenocarcinoma receiving chemotherapy. In this group, 4051 patients were identified with primary tumor resection. The median survival in favor of addition of radiotherapy was 46.3 months vs 35.3 months. Overall survival for 2- and 5- years was 68.4% and 24.8% for surgical resection alone, compared to 77.2% and 39.6% for surgery + radiotherapy. In patients with metastatic rectal adenocarcinoma undergoing chemotherapy, pelvic radiotherapy may be of significant benefit in addition to primary tumor resection.