This trial addressed a clinical question on the role of radiotherapy once the principles of total mesorectal rectal excision had been established and accepted. It demonstrated that even when surgical technique is optimized radiotherapy retains a complementary role to optimize cancer cure in rectal cancer. The authors embarked upon a gargantuan, preparatory work to standardize surgery across multiple centers, but equally worked on similar standardization in radiology and pathology. Apart from the specific results of this trial, the efforts of its investigators contributed to widespread, multipronged improvements in the quality of care for patients with rectal cancer.