Results: Twenty patients were accrued. 55% was male. All patients had clinical T3 N positive disease except one had T4 disease. Pathological response was evaluable in 19 patients. Dworak TRG 1-2 and 3-4 were detected in 36.8% and 63.2% respectively. After median follow-up of 5.93 years, five patients (25%) developed recurrent distant metastatic disease and finally expired. No recurrent disease occurred after 2.39 years. The 5-year DFS and OS were 75% and 80% respectively. Although no statistically significant difference was found, patients with Dworak TRG 1-2 had lower 5-year DFS and OS than those with TRG 3-4 (TRG 1-2, DFS 66.7% vs. TRG 3-4, DFS 100%, p¼.058 and TRG 1-2, OS 66.7% vs. TRG 3-4, OS 100%, p¼.059 respectively). At present, all patients with Dworak TRG 3-4 are alive and have never had recurrent disease. Conclusions: Most locally advanced rectal cancer patients receiving preoperative concurrent CapeOx/RT achieved best Dworak TRG. Long-term outcomes of these patients, especially with good response, were excellent. Larger studies may be needed to determine the association of Dworak TRG and survival. Legal entity responsible for the study: Ramathibodi Comprehensive Cancer Center.