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Will Adjuvant Chemotherapy Improve Outcome After Preoperative Chemoradiation?

  • Bengt Glimelius
  • Peter Nygren
Chapter

Abstract

Adjuvant systemic chemotherapy is standard therapy in many patients with colon cancer since it can prevent recurrences and thus improve survival. The benefits, shown in randomized trials, are sufficiently large for routine use if the recurrence risk is at least reasonably high. Since colon and rectal cancer are regarded as one disease entity essentially separated only by an arbitrary anatomical border, adjuvant chemotherapy should improve outcome also in rectal cancer. Thus, the role of adjuvant chemotherapy in rectal cancer following chemoradiotherapy and surgery is frequently extrapolated from colon cancer without too much consideration of the scientific support for this approach. However, there are biological differences beyond anatomical location between these tumour types; the preoperative (chemo)radiotherapy adds complexity with bearing on the role of adjuvant chemotherapy and, most disturbingly, there is lack of convincing data showing a benefit from adjuvant chemotherapy in rectal cancer. This is particularly the case after preoperative chemoradiation. There is a great need for well-designed trials to answer the fundamental question whether adjuvant chemotherapy in rectal cancer provides any benefit after preoperative chemoradiation.

Keywords

Overall Survival Colon Cancer Rectal Cancer Adjuvant Chemotherapy Total Mesorectal Excision 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of Radiology, Oncology and Radiation ScienceUniversity of Uppsala, Akademiska sjukhusetUppsalaSweden
  2. 2.Department of Oncology and PathologyKarolinska InstitutetStockholmSweden

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