PMID: 8961990Dec 14, 1996Paper

Randomised trial of surgery alone versus surgery followed by radiotherapy for mobile cancer of the rectum. Medical Research Council Rectal Cancer Working Party

Lancet

Abstract

Although surgery is the treatment of choice for rectal cancer, local recurrence is common even after apparently curative resection. We aimed to assess the role of postoperative radiotherapy in reducing rates of local recurrence, and improving disease-free and overall survival in patients with mobile Dukes' stage B and C rectal cancers. We carried out a prospective, randomised trial of surgery alone (n = 235) versus surgery followed 4-6 weeks later by radiotherapy (n = 234), of 40 Gy in 20 fractions of 2 Gy over 4 weeks. The 469 patients, from 46 hospitals in the UK and the Republic of Ireland, were randomised between 1984 and 1989, and followed up for a minimum of 5 years or to death. 284 patients died, 145 of 235 allocated surgery alone and 139 of 234 allocated postoperative radiotherapy. The hazard ratio for overall survival was 0.84 (95% CI 0.65-1.07, p = 0.17). At 5 years' follow-up 79 patients who received surgery alone and 48 who received postoperative radiotherapy had had local recurrence (hazard ratio 0.54 [0.38-0.77], p = 0.001). The corresponding numbers with distant recurrence were 83 and 75 (hazard ratio 0.85 [0.63-1.114], p = 0.18). The hazard ratio for disease-free survival was 0.85 (0.65-1.08; p = 0.18). Radiothe...Continue Reading

References

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Citations

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