Skip to main content
SpringerLink
Log in

When Should Postoperative Radiochemotherapy Be Performed?

  • Chapter
  • First Online:
Multidisciplinary Management of Rectal Cancer

  • 970 Accesses

Abstract

Postoperative radiochemotherapy is recommended for patients with resected stage II-III rectal cancer who did not receive preoperative therapy. In this setting, postoperative radiochemotherapy has been shown to improve local control compared to observation but is associated with higher local recurrence, increased surgical complications, and no opportunity to improve the rate of sphincter preservation compared to preoperative therapy. The extent to which modern adjuvant chemotherapy may attenuate previously reported recurrence risks and applicability of data for patients with low-risk stage II disease following total mesorectal excision is unknown.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Sauer R et al (2012) Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol 30(16):1926–1933

    Article  CAS  PubMed  Google Scholar 

  2. (1985) Prolongation of the disease-free interval in surgically treated rectal carcinoma. Gastrointestinal Tumor Study Group. N Engl J Med 312(23):1465–1472

    Google Scholar 

  3. Krook JE et al (1991) Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med 324(11):709–715

    Article  CAS  PubMed  Google Scholar 

  4. Fisher B et al (1988) Postoperative adjuvant chemotherapy or radiation therapy for rectal cancer: results from NSABP protocol R-01. J Natl Cancer Inst 80(1):21–29

    Article  CAS  PubMed  Google Scholar 

  5. Douglass HO Jr et al (1986) Survival after postoperative combination treatment of rectal cancer. N Engl J Med 315(20):1294–1295

    Article  PubMed  Google Scholar 

  6. Wolmark N et al (2000) Randomized trial of postoperative adjuvant chemotherapy with or without radiotherapy for carcinoma of the rectum: National Surgical Adjuvant Breast and Bowel Project Protocol R-02. J Natl Cancer Inst 92(5):388–396

    Article  CAS  PubMed  Google Scholar 

  7. Willett CG et al (1999) Prognostic factors in stage T3N0 rectal cancer: do all patients require postoperative pelvic irradiation and chemotherapy? Dis Colon Rectum 42(2):167–173

    Article  CAS  PubMed  Google Scholar 

  8. Merchant NB et al (1999) T3N0 rectal cancer: results following sharp mesorectal excision and no adjuvant therapy. J Gastrointest Surg 3(6):642–647

    Article  CAS  PubMed  Google Scholar 

  9. Heald RJ et al (1998) Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978-1997. Arch Surg 133(8):894–899

    Article  CAS  PubMed  Google Scholar 

  10. Enker WE et al (1999) Safety and efficacy of low anterior resection for rectal cancer: 681 consecutive cases from a specialty service. Ann Surg 230(4):544–552. discussion 552-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. van Gijn W et al (2011) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 12(6):575–582

    Article  PubMed  Google Scholar 

  12. National Comprehensive Cancer Network. Rectal cancer (Version 3.2015). NCCN clinical practice guidelines in oncology (NCCN Guidelines®); Available from: http://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf

  13. Andre T et al (2009) Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 27(19):3109–3116

    Article  CAS  PubMed  Google Scholar 

  14. National Institute for Health and Clinical Excellence (NICE). Colorectal cancer: the diagnosis and management of colorectal cancer. National Institute for Health and Care Excellence (NICE) Clinical Guidelines November 2011 December 2014; Available from: https://www.nice.org.uk/guidance/cg131/resources/guidance-colorectal-cancer-pdf

  15. Glimelius B et al (2013) Rectal cancer: ESMO clinical practice gidelines for diagnosis, treatment and follow-up. Ann Oncol 24(Suppl 6):vi81–vi88

    Article  PubMed  Google Scholar 

  16. Schrag D et al (2014) Neoadjuvant chemotherapy without routine use of radiation therapy for patients with locally advanced rectal cancer: a pilot trial. J Clin Oncol 32(6):513–518

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA

    Jeffrey R. Olsen MD

  2. Departments of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, 830 Harrison Avenue, Boston, MA, 02118, USA

    Lisa A. Kachnic MD

Authors
  1. Jeffrey R. Olsen MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisa A. Kachnic MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lisa A. Kachnic MD .

Editor information

Editors and Affiliations

  1. Dept. of Radiation Oncology, Università Cattolica S Cuore, Rome, Italy

    Vincenzo Valentini

  2. Head, Div. Clinical Oncology Research, University Clinic Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle, Sachsen-Anhalt, Germany

    Hans-Joachim Schmoll

  3. Department of Surgery, Leiden Univ Med Ctr, Leiden, The Netherlands

    Cornelis J. H. van de Velde

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer-Verlag Berlin Heidelberg

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Olsen, J.R., Kachnic, L.A. (2018). When Should Postoperative Radiochemotherapy Be Performed?. In: Valentini, V., Schmoll, HJ., van de Velde, C. (eds) Multidisciplinary Management of Rectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-43217-5_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-43217-5_30

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43215-1

  • Online ISBN: 978-3-319-43217-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation