…and a two-edged sword in their hands

Abstract

Willem van Gijn and colleagues 1 van Gijn W Marijnen CAM Nagtegaal ID et al. for the Dutch Colorectal Cancer GroupPreoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol. 2011; (published online May 18.)https://doi.org/10.1016/S1470-2045(11)70097-3 Summary Full Text Full Text PDF Scopus (1146) Google Scholar report mature (10 year) results in terms of local recurrence and survival from the Dutch total mesorectal excision (TME) trial in rectal cancer. The trial had excellent quality assurance for surgery and pathology and, although many changes in staging and management have taken place since the original design, the results remain relevant today. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trialFor all eligible patients, preoperative short-term radiotherapy reduced 10-year local recurrence by more than 50% relative to surgery alone without an overall survival benefit. For patients with a negative resection margin, the effect of radiotherapy was irrespective of the distance from the anal verge and led to an improved cancer-specific survival, which was nullified by an increase in other causes of death, resulting in an equal overall survival. Nevertheless, preoperative short-term radiotherapy significantly improved 10-year survival in patients with a negative circumferential margin and TNM stage III. Full-Text PDF