Adjuvant Treatment for Locally Advanced Rectal Cancer Patients After Preoperative Chemoradiotherapy: When, and for Whom?

Adjuvant chemotherapy for rectal cancer: Is it needed?

“…In line with this, two other studies by De Stefano et al [57] and Janjan et al [58] found that patients who responded to preoperative chemoradiotherapy benefited from adjuvant chemotherapy, however no benefit was observed in the nonresponders group. Such observations also have sound scientific basis, since rectal cancers are highly heterogenous tumours and preoperative chemotherapy may enable to predict favourable tumour biology, which may respond to subsequent adjuvant chemotherapy.…”

“…The trial compares FOLFOX vs observation alone in patients with T34, N1, M0 who were treated with preoperative chemotherapy and showed poor response. The rationale of the study is based on the previous observations that only certain groups of patients with rectal cancer may benefit from adjuvant chemotherapy [57,87] . Since rectal cancer is a highly heterogenous disease, more trials are needed to take a targeted approach when evaluating the benefits of adjuvant chemotherapy.…”

Prognostic value of pathological node status after neoadjuvant radiotherapy for rectal cancer

“…Kim and colleagues recently demonstrated that ypN status underestimated the risk of future distant metastasis compared with the corresponding pathological nodal category obtained after surgery alone. Studies that evaluated ypN status as a prognostic factor following neoadjuvant radiotherapy have reported contradictory results. In some series ypN category was associated with overall and disease‐free survival, whereas others failed to demonstrate it was an independent factor.…”

Rectal cancer patients after neoadjuvant radiotherapy (30Gy/10f) with negative lymph node may not benefit from postoperative adjuvant chemotherapy: a retrospective study

“…Kiran [11] presented the same point of view after comparing the prognosis between the patients with and without adjuvant chemotherapy. De Stefano [20] proposed that ypN+ patients are a candidate for intensified adjuvant chemotherapy. Fig.…”