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.
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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):1926–1933CrossRefPubMedGoogle Scholar
(1985) Prolongation of the disease-free interval in surgically treated rectal carcinoma. Gastrointestinal Tumor Study Group. N Engl J Med 312(23):1465–1472Google Scholar
Krook JE et al (1991) Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med 324(11):709–715CrossRefPubMedGoogle Scholar
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):21–29CrossRefPubMedGoogle Scholar
Douglass HO Jr et al (1986) Survival after postoperative combination treatment of rectal cancer. N Engl J Med 315(20):1294–1295CrossRefPubMedGoogle Scholar
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):388–396CrossRefPubMedGoogle Scholar
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):167–173CrossRefPubMedGoogle Scholar
Merchant NB et al (1999) T3N0 rectal cancer: results following sharp mesorectal excision and no adjuvant therapy. J Gastrointest Surg 3(6):642–647CrossRefPubMedGoogle Scholar
Heald RJ et al (1998) Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978-1997. Arch Surg 133(8):894–899CrossRefPubMedGoogle Scholar
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 552-4CrossRefPubMedPubMedCentralGoogle Scholar
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):575–582CrossRefPubMedGoogle Scholar
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):3109–3116CrossRefPubMedGoogle Scholar
Glimelius B et al (2013) Rectal cancer: ESMO clinical practice gidelines for diagnosis, treatment and follow-up. Ann Oncol 24(Suppl 6):vi81–vi88CrossRefPubMedGoogle Scholar
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):513–518CrossRefPubMedPubMedCentralGoogle Scholar