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  2. References
  • Rothwell PM, Price JF, Fowkes FGR, Zanchetti A, Roncaglioni MC, Tognoni G, et al. Short-term effects of daily aspirin on cancer incidence, mortality and non vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials. Lancet 2012; 379: 16021612.The analysis included almost eight thousand people randomised aspirin or no aspirin to reduce vascular events. Allocation to aspirin reduced subsequent deaths from cancer (odds ratio 0·85, 95 per cent confidence interval 0·76 to 0·96, P = 0·008), particularly from five years onwards.
  • Rothwell PM, Wilson M, Price JF, Belch JFF, Meade TW, Mehta Z. Effect of aspirin on risk of cancer metastasis: a study of incident cancers during randomised controlled trials. Lancet 2012; 379: 15911601.Some 987 people in aspirin prevention trials developed a new solid organ cancer. Prior allocation to the aspirin group reduced the rate of developing cancer with distant metastasis: hazard ratio 0·64, 95 per cent confidence interval 0·48 to 0·84, P = 0·001. The effect was most marked for adenocarcinomas: 0·52, 0·35 to 0·75, P = 0·0006.
  • Biere SS, Henegouwen MIVB, Maas KW, Bonavina L, Rosman C, Garcia JR et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 2012; 379: 18871892.Some 115 patients with resectable tumours were included. Three patients died (one open, two minimally invasive). Patients who had minimally invasive surgery had a lower rate of pulmonary infection in the first fortnight (5 versus 16; relative risk 0·3, 95 per cent confidence interval 0·12 to 0·76, P = 0·005).
  • Van Hagen P, Hulsof MCCM, van Lanschot JJB, Steyerberg EW, Henegouwen MIBV, Wijnhoven BPL et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 2012; 366: 20742084.The neoadjuvant chemoradiotherapy lasted five weeks in this study that included 368 patients. Treated patients had a higher rate of complete resection with no tumour within 1mm of resection margins: 92 versus 69 per cent (P < 0·001). Median overall survival rates were 49 and 24 months, respectively, P = 0·003.
  • Joensuu H, Eriksson M, Sundby HK, Hartmann JT, Pink D, Schutte J et al. One versus three years of adjuvant imatinib for operable gastrointestinal stromal tumor: a randomized trial. JAMA 2012; 307: 12651272.In this study that included 400 patients, a quarter of those randomized to the longer course of imatinib failed to complete the treatment. Overall five year survival was improved in the three year group from 81·7 to 92 per cent, hazard ratio 0·45, 95 per cent confidence interval 0·22 to 0·89, P = 0·02.
  • Frozanpor F, Lundell L, Segersvard R, Arnelo U. The effect of prophylactic transpapillary stent insertion on clinically significant leak rate following distal pancreatectomy: results of a prospective controlled clinical trial. Ann Surg 2012; 255: 10321036.Stenting added a mean of one hour to the duration of operation in this study that included 58 procedures. Stenting did not reduced the rate of subsequent pancreatic fistula (6 versus 11), or shorten postoperative hospital stay 13·4 versus 19·4 days (P = 0·07).
  • Dewdney A, Cunningham D, Taberno J, Capdevila J, Glimelius B, Cervantes A et al. Multicenter randomized phase II clinical trial comparing neoadjuvant oxaliplatin, capecitabine and preoperative radiotherapy with and without cetuximab followed by total mesorectal excision in patients with high risk rectal cancer (EXPERT-C). J Clin Oncol 2012; 30: 16201627.In this study that included 165 patients, the addition of cetuximab to the neoadjuvant regimen did not improve the rate of complete tumour response, but it did improve overall survival in patients with KRAS/BRAF wild type rectal cancer.
  • Alberts SR, Sargent DJ, Nair S, Mahoney MR, Mooney M, Thibodeau NM et al. Effect of oxaliplatin, fluorouracil and leucovorin with or without cetuximab on survival among patients with resected stage III colon cancer. A randomized trial. JAMA 2012; 307: 13831393.This study included 2686 patients. There was no evidence of improved disease-free survival with the addition of cetuximab after three years in patients with wild-type KRAS cancer: 71·5 per cent, versus 74·6 per cent in controls (P = 0·08), or in those with mutated KRAS cancer: 65 versus 67·1 per cent (P = 0·38).
  • Baldwin C, Spiro A, Ahern R, Emery PW. Oral nutrition interventions in malnourished patients with cancer: a systematic review and meta-analysis. J Nat Cancer Inst 2012; 104: 371385.Thirteen studies with 1414 participants were included. There were no significant increases in energy intake or weight gain in supplemented patients. Some aspects of quality of life were measurably improved, but there was no demonstrable effect on cancer mortality.
  • Marimuthu K, Varadhan K, Ljungqvist O, Lobo D. A meta-analysis of the effect of combinations of immune modulating nutrients on outcome in patients undergoing major open gastrointestinal surgery. Ann Surg 2012; 255: 10601068.This analysis included 26 trials that enrolled 2496 patients. Although there was no significant improvement in perioperative mortality, there was strong evidence of a reduction in postoperative infections (risk ratio 0·64, 95 per cent confidence interval 0·55 to 0·74) and duration of hospital stay: mean difference − 1·88 days, 95 per cent confidence interval − 2·91 to − 0·84 days.
  • The trials listed here are added to the Scientific Surgery Archive which contains all randomized clinical trials in Surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. The Archive, which is fully searchable, can be found on the BJS website ( together with other useful features for surgeons such as Instructions to Authors, EarlyView of accepted articles and on-line Your Views.