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European Model of Stratification
based on MRI risk categorization
LOW RISK:
T1-2 N0
T3 < 5mm
(mid/upper)
MRF clear
INTERMEDIATE RISK:
T3 > 5mm
N1-2
MRF clear (>1mm)
(EMVI +)
High RISK:
T4
MRF involved
(EMVI -)
TME
Preoperative 5x5 Gy
or chemoradiation
or (chemo +) TME alone
Preoperative
chemoradiation
TME
Selected or no RT ???
Optimized CRT as definitive treatment