Total Mesorectal Excision(TME) With Lateral Lymph Node Dissection Versus TME After Neoadjuvant Chemo-radiotherapy

This study compares two surgical approaches for rectal cancer: one where surgery alone removes the rectum along with nearby lymph nodes on the sides of the pelvis (lateral lymph node dissection), versus a two-step approach where chemotherapy and radiation are given first, followed by standard surgery. **You may be eligible if...** - You have been diagnosed with rectal cancer (adenocarcinoma) confirmed by biopsy, located below the peritoneal fold (the lower part of the rectum) - Your cancer is at clinical stage III (T1–T3 with lymph node involvement, no distant spread) - Your tumor can be fully removed with surgery - You have not previously received chemotherapy or pelvic radiation for any cancer - Your treatment plan has been confirmed by a multidisciplinary team using MRI and rectal ultrasound **You may NOT be eligible if...** - You have a history of other cancers - Your cancer involves the lymph nodes above the peritoneal reflection (upper rectal involvement) Talk to your doctor to see if this trial is right for you.