Use of adjuvant chemotherapy in stage C (III) rectal cancer: Comparison of data from matched patients in a teaching hospital's clinico-pathological database
Article first published online: 23 APR 2012
© 2012 Wiley Publishing Asia Pty Ltd
Asia-Pacific Journal of Clinical Oncology
Volume 8, Issue 4, pages 346–355, December 2012
How to Cite
KHO, P., CHAPUIS, P. H., BEALE, P., BOKEY, L., DENT, O. F. and CLARKE, S. (2012), Use of adjuvant chemotherapy in stage C (III) rectal cancer: Comparison of data from matched patients in a teaching hospital's clinico-pathological database. Asia-Pacific Journal of Clinical Oncology, 8: 346–355. doi: 10.1111/j.1743-7563.2012.01519.x
- Issue published online: 27 NOV 2012
- Article first published online: 23 APR 2012
- Accepted for publication 24 December 2011.
- gastrointestinal cancers;
- medical oncology;
- surgical oncology
Aims: Controversy continues regarding the treatment of patients with resectable rectal cancer, particularly in regard to the effects of adjuvant therapies on long-term survival. The benefits of adjuvant chemotherapy alone in patients with stage III rectal cancer after curative resection remain unclear. The aim of this study was to compare the overall survival of patients who had received adjuvant chemotherapy after resection of a stage III rectal cancer (111 patients) with the survival of a historical control group who had surgery alone before chemotherapy was introduced (129 patients).
Methods: Treatment and outcomes data were drawn from a prospective hospital registry of consecutive patients who had a resection for stage III rectal cancer.
Results: The estimated Kaplan–Meier overall 5-year survival rate in patients who received chemotherapy (68.7%, 95% CI 58.3–77.1%, log-rank P < 0.001) was improved compared with the historical controls (40.5%, 95% CI 31.4–49.5%, log–rank P < 0.001 ). No systematic differences between the treated and control group were found.
Conclusion: This study has shown improved survival after adjuvant chemotherapy in patients with stage III rectal cancer as compared with historical controls treated by surgery alone. Hence, there could be subsets of patients whom when treated with surgery in a specialized surgical unit, may benefit from chemotherapy and spared the toxicities of adjuvant radiotherapy. This should be explored further in a cooperative trial group setting.