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All three patients remain well at follow-up with no evidence of recurrence. All three cases demonstrate an individualised approach, taking into account specific factors relating to both patient and disease. In all cases, the presence of active chronic radiation proctitis meant that primary colorectal anastomosis was not safe, thus, alternative approaches were taken. It is essential to tailor treatment according to patient-specific and disease-specific factors. It is essential to tailor treatment according to patient-specific and disease