Adjuvant fluorouracil-based chemotherapy does not improve survival or distant recurrences in patients with rectal cancer, according to a recent study published in The Lancet Oncology.
However, adjuvant chemotherapy may have some benefit in disease-free survival and distant recurrence for those patients with a tumor 10 to 15 cm from the anal verge.
Researchers led by Anne Breugom, MD, and Marloes Swets, MD, of Leiden University Medical Centre in the Netherlands compiled information from online databases in order to identify European randomized, controlled, phase 3 trials comparing observation with adjuvant chemotherapy after preoperative radiotherapy and surgery for patients with non-metastatic rectal cancer.
They conducted a meta-analysis of four trials that included data from 1,196 patients with stage II or III disease and who had resection.
The researchers found no significant difference in overall survival between patients who received adjuvant chemotherapy and those who underwent observation.
However, in subgroup analyses, patients with a tumor 10 to 15 cm from the anal verge had an improved disease-free survival when treated with adjuvant chemotherapy compared to observation.
“Further studies of preoperative and postoperative treatment for this subgroup of patients are warranted,” the authors concluded.
The authors did a meta-analysis of individual patient data to compare adjuvant chemotherapy with observation for patients with rectal cancer. Overall, adjuvant fluorouracil-based chemotherapy did not improve overall survival, disease-free survival, or distant recurrences.