AIM:To discuss the rationality of extended radicalresection (ERR) and to guide the surgical treatment ofrectal cancer.METHODS:Total 211 patients who underwent ERR from1981 to 1987 (follow-up rate of 94.8 %) were selected tostudy the patterns of lymphatic metastasis and therapeuticeffect.The control group was made of 293 patients withrectal cancer who underwent conventional radicalresection (CRR) and its follow-up rate was 98.5 %.Thelymph node specimens,obtained by the triple-approachlymph node resection during the radical resection of rectalcancer,were studied by conventional pathological method.The extended radical resection,guided by the patternsof lymphatic metastasis,was applied in the clinicalpractice.RESULTS:The incidence of lymphatic metastasis inChinese patients with advanced rectal cancer was 43.6 %,and that of the upper 2nd and 3rd groups and the lateralgroup was 14.2 %,10.9 % and 11% respectively.The 5,10-year-survival rates of the ERR were 68.0 % and 47.0 %,respectively,which were much higher than those of theconventional radical resection (42.9 % and 25.3 %).CONCLUSION:The ERR for rectal cancer removes all thelymph nodes,prevents possible metastasis and finallyimproves the survival rate. AIM: To discuss the rationality of extended radical response (ERR) and to guide the surgical treatment ofrectal cancer. METHODS: Total 211 patients who underwent ERR from 1981 to 1987 (follow-up rate of 94.8%) were selected tostudy the patterns of lymphatic metastasis and therapeuticeffect.The control group was made of 293 patients withrectal cancer who underwent conventional radicalresection (CRR) and its follow-up rate was 98.5% .Thelymph node specimens, obtained by the triple-approach lymph node resection during the radical resection of rectalcancer, were studied by conventional pathological method. The extended radical resection, guided by the patterns of lymphatic metastasis, was applied in the clinical practice. Results: The incidence of lymphatic metastasis in Chinese patients with advanced rectal cancer was 43.6%, and that of the upper 2nd and 3rd groups and the lateral group was 14.2%, 10.9% and 11% respectively. The 5,10-year survival rates of the ERR were 68.0% and 47.0%, respectively, whi ch were much higher than those of the conventional radical resection (42.9% and 25.3%). CONCLUSION: The ERR for rectal cancer removes all the lymph nodes, prevents possible metastasis and finally dimproves the survival rate.