Post-surgery chemotherapy in early rectal cancer is associated with improved outcomes

This study investigated the safety of localized surgery followed by chemotherapy compared with total mesorectal excision (TME; bowel and lymph nodes around the tumor are removed) in early stages (T0 to T1) of rectal cancer. Researchers suggested that local surgery followed by chemotherapy improves long term outcomes in early stages of rectal cancer.

TME is the standard treatment to rectal cancer. Radical surgery is associated with high rates of post-surgery complications (38-54% of the patients).

Prior studies showed that local surgery is a less invasive alternative for radical surgery. However, it is only associated with improved outcomes if combined with chemotherapy before surgery to treat early stage rectal cancer. The effectiveness of local surgery combined with chemotherapy after surgery is still not known.

This study reviewed 22 other studies, including information about 804 rectal cancer patients. 35.1% of the patients had an early stage tumor. The average follow-up period was 51 months.

The recurrence rate (when the cancer comes back) was 5.8% in patients with T1 tumors and 13.8% for patients with T2 tumors. The overall average disease-free survival was 88%. 15.1% of patients had post-surgery complications (such as bleeding or pain).

This study showed that localized surgery followed by chemotherapy is associated with improved long-term T1 rectal cancer outcomes. The aurthors suggested that T2 cancer patients should be offered radical surgery.