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One of the aims of Colorectal Disease is to be the pan-European forum for the dissemination of colorectal research. In the past it has been difficult, for obvious reasons, to attract papers from Eastern Europe but this has changed in recent years. The present paper from Russia is an excellent example of great research that is timely and clinically relevant. In a Phase II trial the authors set out to analyse the effect of adding local hyperthermia to neo-adjuvant chemoradiotherapy in patients with true T4 rectal cancer. The results are inspiring, over 90% R0 resection, major tumour regression in over 50%, minimal toxic treatment reaction, a 2-year disease-free survival of 83% and a 2-year local recurrence rate of 13.6%. This may seem high but should be seen in the context of large (median 9 cm) T4 tumours with negative histological features. The present results certainly support the authors' call for a multicentre, possibly multinational, randomized trial.