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clinical oncology. They are helpful in the selection of treatment; provide insights into the disease process and the therapeutic response. This study attempts to observe the survival of rectal adenocarcinoma and to find prognostic factors and other variables potentially associated with outcome of operated rectal adenocarcinoma. Methods: It's a retrospective study based on 91 patients with operated rectal adenocarcinoma collected at the Medical Oncology Department of Hassan II University Hospital for a period of 4 years between January 2014 and June 2017. Various prognostic factors had been identified through univariate (Kaplan-Meier) then multivariate (Cox) analyze, namely: age, sex, tumor localization, degree of differentiation, stage, tumor recurrence, ACE level, neoadjuvant therapy and adjuvant chemotherapy. Results: The mean age was 59 years (6 14.14) with extremes "24-86". These were 40% men and 60% women. At endoscopic examination the tumor was located: in the middle rectum in 30.8%; 36.3% in the lower rectum and 33% in the upper rectum. Histologically, the biopsy showed that liberkunian adenocarcinoma was well differentiated in 56%, moderately differentiated in 42% and in 2% poorly differentiated. The carcinoembryonic antigen revealed a rate greater than 5 ng/ml in 25% of patients. Neo-adjuvant treatment with concomitant radiochemotherapy was performed in 61.5% and radiotherapy for 24%. Histopathological examination classified the patients according to the TNM classification with: 7% of patients in stage I, 30% in stage II, 54% in stage III and 9% in stage IV. After surgery 78 patients (86%) received adjuvant chemotherapy. Average overall survival was 25 months. In addition, 23% of patients had a recurrence, median-free survival was 29month. Adjuvant therapy was the only prognostic factor influencing survival: mean survival in the group receiving adjuvant chemotherapy was 32 months vs 14 months in the surveillance group with a very significant difference (p ¼ 0.006). Conclusion:In our series adjuvant therapy was an important prognostic factor influencing overall survival, our results correlate with those in the literature.