title: Adjuvant chemotherapy for rectal cancer: Is it needed?
abstract: Adjuvant chemotherapy has become a standard treatment of advanced rectal cancer in the West. The benefits of adjuvant chemotherapy after surgery alone have been well established. However, controversy surrounds the use adjuvant chemotherapy in patients who received preoperative chemoradiotherapy, despite it being recommended by a number of international guidelines. Results of recent multicentre randomised control trials showed no benefit of adjuvant chemotherapy in terms of survival and rates of distant metastases. However, concerns exist regarding the quality of the studies including inadequate staging modalities, out-dated chemotherapeutic regimens and surgical approaches and small sample sizes. It has become evident that not all the patients respond to adjuvant chemotherapy and more personalised approach should be employed when considering the benefits of adjuvant chemotherapy. The present review discusses the strengths and weaknesses of the current evidence-base and suggests improvements for future studies.
authors.affiliation: Kristijonas Milinis, Faculty of Medicine, University of Liverpool, Liverpool L69 3GE, United Kingdom.
authors.forename: Kristijonas
authors.initials: K
authors.lastname: Milinis
authors.affiliation: Kristijonas Milinis, Faculty of Medicine, University of Liverpool, Liverpool L69 3GE, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Thornton
authors.affiliation: Kristijonas Milinis, Faculty of Medicine, University of Liverpool, Liverpool L69 3GE, United Kingdom.
authors.forename: Amir
authors.initials: A
authors.lastname: Montazeri
authors.affiliation: Kristijonas Milinis, Faculty of Medicine, University of Liverpool, Liverpool L69 3GE, United Kingdom.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Rooney
keywords: Adjuvant chemotherapy; Rectal cancer