Total Neoadjuvant Therapy for Lymph Node-positive Adenocarcinoma of the OESophagus and Oesophagogastric Junction

This study tests a "total neoadjuvant therapy" (TNT) approach — giving chemotherapy and radiation before surgery — for people with lymph node-positive rectal cancer that has spread to the area just above the rectum. TNT aims to shrink the tumor as much as possible before surgery to improve outcomes. **You may be eligible if...** - You are 18–75 years old with rectal cancer (adenocarcinoma) - Your cancer is confirmed to have positive lymph nodes in the perirectal region - You have not had prior treatment for this cancer - Your general health allows you to tolerate chemotherapy and radiation **You may NOT be eligible if...** - Your cancer has spread to distant organs (Stage IV) - You have had prior pelvic radiation - You have serious heart, kidney, liver, or lung disease - You are pregnant or breastfeeding - You have had another cancer in the past 5 years (some exceptions apply) Talk to your doctor to see if this trial is right for you.