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Preoperative treatment of locally advanced rectal cancer

Schrag D, Shi Q, Weiser MR, Gollub MJ, Saltz LB, Musher BL et al.

N Engl J Med 2023; 389: 322-334.

Some 1194 patients with stage T2 or T3 rectal cancer were randomized to neoadjuvant chemoradiotherapy (standard care) or chemotherapy alone. Five-year disease-free survival was 80.8 per cent after chemotherapy alone compared to 78.6 per cent after standard care, P=0.005 for noninferiority. Overall survival rates were similar.

Comment: This is important as it could change standard care. Surgeons have never been keen to operate on recently irradiated tissue.

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