Defining the needs for adjuvant therapy of rectal and colonic cancer

The Surgical Clinics of North America
W E EnkerL Rotstein

Abstract

Current trials concerned with the adjuvant therapy for large bowel cancer demonstrate for the first time that improvements in survival through the use of adjuvant therapy may be possible in rectal cancer. Similar results in well-designed studies are not evident for colonic cancer. These trials deserve confirmation. In addition, they demonstrate the biologic difference in the behavior of colonic and rectal cancer despite similar requirements in defining curative surgical resection. A comparison of trials unique to individual institutions suggests that the lenient criteria for patient selection and the use of historical control groups make the data from these studies impossible to interpret for extrapolation to wide clinical use. The variations in the survival rates of historical groups, both among different studies and within the same study, suggest that the design of adjuvant therapy programs without concurrent surgically treated control groups will predictably produce a study of limited value, but one that is guaranteed to generate continued controversy. Uniformity of language, staging, and method of reporting is invaluable if individual trials of adjuvant therapy are to become comparable. The development and widespread use of...Continue Reading

Citations

May 1, 1989·The British Journal of Surgery·D J GallowayM A Friedman
Sep 1, 1983·Journal of Surgical Oncology·J LundyM Berman
Aug 1, 1988·Diseases of the Colon and Rectum·J M DevesaC Avila
Jul 28, 2013·Asian Pacific Journal of Cancer Prevention : APJCP·Wei Ching LeeVincent Chee Ee Phua
Dec 1, 1984·Diseases of the Colon and Rectum·B J Cummings

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