Does chemotherapy after complete removal of rectal cancer improve outcomes?

This study investigated the differences in following the guidelines for advanced rectal cancer treatments. Researchers suggested chemotherapy after the complete removal of rectal cancer improves survival.

This year, an estimated 147,950 adults in the US will be diagnosed with colorectal cancer. Of these, 43,340 will be rectal cancer. The US National guidelines for the treatment of advanced rectal cancer are surgery followed by chemotherapy. However, the current standard treatment is long-course radiation and chemotherapy (LCRC) followed by surgery. Complete response after LCRC before surgery is about 15 to 20%.

No differences were so far reported in overall survival by adding chemotherapy treatment after surgery. The effects of receiving chemotherapy after surgery are still not clear and therefore poorly used.

This study included information about 2421 patients with locally advanced rectal cancer. These patients underwent LCRC followed by surgery and achieved complete tumor response (group 1). Some of these patients received chemotherapy after surgery (group 2). The overall survival (OS; time from treatment to death by any cause) was assessed.

The 5-year OS of patients from group 2 (92%) was longer than of the patients from group 1 (85%). These patients had a 40% improvement in the odds of a better OS.

The use of chemotherapy after surgery among hospitals was 32%. Even though this percentage is increasing over time, two-thirds still do not receive the recommended therapy. Academic hospitals were high chemotherapy utilizers (54.9%) when compared to other hospitals and health centers (45.9%).

This study concluded that chemotherapy after surgery improves the outcomes of patients with locally advanced rectal cancer. Therefore, the authors recommend that national guidelines should be followed.

This study is based on medical records. Some information might have been missing.