Summary and Conclusions A series of 122 patients with adenocarcinoma of the rectum who had abdominopelvic lymph node dissection five or more years ago is presented. Metastases to abdominopelvic extramesenteric lymph nodes which would not have been removed by the standard types of resection of the rectum were found in 11 cases (9 per cent). There was 66 (54 per cent) five-year survivors. The survival rate for those classified according to Dukes’ method as A, B and C was 83, 58 and 40 per cent, respectively. Two patients of 11 having metastases to abdominopelvic extramesenteric lymph nodes which would not have been removed by the usual procedures for cancer of the rectum lived five or more years. Of 35 patients who died of residual or metastatic cancer, 22 (60 per cent) had residual pelvic malignant disease.