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ón Científica Pulmón y Ventilación Mecánica. BACKGROUND GRECCAR 2 was the first multicentre, randomised trial to compare local excision with total mesorectal excision in downstaged low rectal cancer. Encouraging oncological results were noted at 3 years' follow-up but needed to be corroborated with longer follow-up. In this study, we aimed to report the 5-year oncological outcomes, including local recurrence, metastatic disease, and survival. METHODS Patients age 18 years and older with T2T3 low rectal cancer, of maximum size 4 cm, who