Would you offer treatment according to the PROSPECT trial for rectal cancer in which an involved lymph node approaches the circumferential resection margin (CRM)?

Yes, if the goal is fertility preservation. One can start with Folfox chemotherapy and restage afterwards. If good response and the CRM is clear then proceed with surgery and if not, you can discuss doing chemoRT at that time.

Yes, I would consider chemo alone.

Without knowing the exact T-stage and tumor characteristics, one cannot, for certain, know that this patient would fit the exact PROSPECT eligibility criteria.

However, knowing the data does give us an option for some patients who would want to consider fertility pre...