The US NCCN clinical practice guidelines are currently the more common international guidelines for cancer treatment. Since its introduction to China in 2007, it has greatly helped to improve the standardized treatment of colorectal cancer in China. Before that, we need to clarify one concept: the scope of NCCN rectal cancer treatment guideline is different from the 15cm distal colon that we usually think of, but refers to the colon of 12cm from the anus as determined by rigid tube proctoscopy. This is very important because the anatomical characteristics, the pattern of recurrence and metastasis, and the choice of treatment for rectum above 12cm from the anus are different from those of colon. [Interpretation 1] Preoperative staging is important The basis of developing rectal cancer treatment plan is preoperative staging. Pre-operative staging of rectal cancer is far more important than colon cancer, mainly because the value of adjuvant radiotherapy in rectal cancer treatment has obtained clear evidence and become the gold standard of treatment for some rectal cancers, without pre-operative staging it is impossible to determine neoadjuvant treatment. In addition, rectal cancer must have accurate T-stage to determine whether it is suitable for local resection. Currently, preoperative staging of rectal cancer in China is only performed in larger hospitals or specialized hospitals, and most hospitals are not yet able to routinely perform it. The main methods of preoperative staging of rectal cancer include ultrasound endoscopy and rectal MRI, both of which have similar sensitivity and specificity, especially rectal MRI can determine the satisfaction of total mesenteric resection, which has better intuition and is favored by most clinical surgeons. It is worth noting that MRI examination of rectal cancer staging is different from general MRI examination and requires specialized techniques. Ultrasound endoscopic staging is more accurate for T1 and T2 staging of tumors, so it is more suitable for earlier lesions that may be locally resected. Interpretation 2] The pathological report emphasizes three points: the number of lymph nodes >12 is required for routine examination of rectal cancer, and the number of lymph nodes detected is also of great concern, because the number of lymph nodes detected can reflect the scope of surgical resection and debridement as well as the standardization of pathological examination. Especially for patients with stage I and II rectal cancer, the number of lymph nodes detected is more important and is decisive in the decision of adjuvant treatment. However, the overall number of lymph nodes detected in China is too far from the requirement, and about 60% of pathology reports have less than 12 lymph nodes detected, which will be very unfavorable to standardized treatment. Overall, the number of lymph nodes in rectal cancer is less than that in colon cancer, and the number of lymph nodes after radiotherapy is often even less. Emphasis on reporting of circumferential margin status Among the requirements for reporting of tumor margins, the guidelines highlight the importance of reporting the status of circumferential (radial) margins in addition to the routine reporting of distal and proximal margins that were emphasized in the past.