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Title of Journal: Int J Colorectal Dis

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Abbravation: International Journal of Colorectal Disease

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Springer Berlin Heidelberg

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DOI

10.1016/0741-5214(86)90447-7

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1432-1262

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A systematic review and metaanalysis of adjuvant

Authors: Fausto Petrelli Andrea Coinu Veronica Lonati Sandro Barni
Publish Date: 2014/11/30
Volume: 30, Issue: 4, Pages: 447-457
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Abstract

Current guidelines support the use of adjuvant chemotherapy CT following neoadjuvant chemoradiotherapy CTRT and surgery to treat rectal cancer although clinical trials have provided little evidence that it is effective We performed a systematic review of published studies to assess whether adjuvant CT improves outcome after neoadjuvant therapy and radical surgery in cases of rectal cancerWe conducted an electronic database search for randomized and nonrandomized studies in PubMed EMBASE Web of Science Scopus and the Cochrane Register of Controlled Trials We then carried out a metaanalysis by using the fixed or randomeffects models The primary endpoint was 5year overall survival OS reported as odds ratios ORs and 95  confidence intervals CIsTwo randomized controlled trials RCTs one pooled analysis of five RCTs and 10 retrospective studies that included a total of 5457 patients matched our selection criteria Metaanalysis showed that for rectal cancer patients treated with surgery and neoadjuvant CTRT adjuvant CT improves 5year OS OR 064 95  CI 046–088 p = 0006 and 5year diseasefree survival DFS OR 071 95  CI 06–083 p  00001 The 5year OS benefit was significantly larger in downstaged patients and in retrospective series A better DFS was instead noted in all studies due to a reduced risk of local relapse

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