- Pathological examination of rectal cancer specimens after total mesorectal excision (TME) surgery or pre-operative chemoradiotherapy can provide important prognostic information and assess treatment response. This includes evaluating the circumferential resection margin (CRM) and quality of mesorectal excision. - A close or positive CRM is a strong predictor of local recurrence. Pre-operative chemoradiotherapy can reduce but not eliminate CRM involvement. The plane of surgery and tumour characteristics also impact local recurrence risk. - Assessing tumour regression grade after chemoradiotherapy allows prediction of survival and recurrence. A good regression grade correlates with improved outcomes.