Rectal cancer T4N2Mx belongs to stage IIIC or IV, which needs to be staged more accurately after further perfect examination to determine the presence of distant metastasis. Rectal cancer T4 refers to the tumor invading the peritoneal visceral layer covering the outer rectum, or invading or adhering to the surrounding organs or structures, where T4a refers to the former, invading the peritoneal visceral layer, and T4b refers to the latter.N2 refers to the presence of 4 or more regional lymph node metastasis, N2a refers to 4~6, and N2b refers to 7 or more. M0 refers to the absence of distant metastasis and M1 is the presence of distant metastasis, which can be categorized as M1a, M1b, and M1c according to the number and location of distant metastasis.Mx refers to the presence of distant metastasis that cannot be assessed, and generally requires PET-CT (positron emission computed tomography) and other tests to improve the whole body examination and to determine the presence or absence of distant metastasis. If there is no distant metastasis after further examination, it is T4N2M0, which belongs to IIIC; if there is distant metastasis, it is T4N2M1, which belongs to stage IV. It is recommended that the patient consult the doctor in time, follow the doctor’s instructions for further examination, improve the evaluation and choose the appropriate treatment plan.