Ca rectum trials

arunmp's version from 2017-12-14 09:25

Preop RT "Swedish Rectal Cancer Trial NEJM, 1997

Question Answer
Patient groupResectable rectal CA <80yo
Arms in swedish trialPreop 25 Gy/5fx (no chemo) then surgery vs. surgery alone
Conclusion of swedish trial"OS benefit with pre-op RT.Pre-op RT reduces LR and improves survival in resectable rectal CA.
5-yr LR with preoprt+surgery v/s surgery alone11% vs. 27%
5-yr OS with preoprt+surgery v/s surgery alone58% vs. 48%.
13-yr OS 38% vs 30%
13-yr LR 9% vs 27%
Only trial to show survival benefit,whyNote that blunt resection was used in this study, not TME.TME is believed to have negated the survival benefit seen here in later studies
Which study showed a benefit in OS and what is the likely reason why?because surgery arm tme was not done