sebag-montefiore et al., asco 2006 @ 3y preop. rt + op (n=674) op + rct in crm + (n=676) hazard-...
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Sebag-Montefiore et al., ASCO 2006
@ 3yPreop. RT
+ OP(n=674)
OP + RCT in CRM +(n=676)
Hazard-Ratio
(95%CI)
Local recurence 4.7% 11.1%2.5
(1.61-3.79)
Disease free survival
79.5% 74.9%1.31
(1.02-1.67)
Overall survival 80.8% 78.7%1.25
(0.98-1.59)
MRC CR07: 5x5 TME vs. TME RCT in CRM+
CAO/ARO/AIO-94
TMETME
TMETME
RR
Sauer et al. N Eng J Med 2004
823 patients
Primary endpoint: overall survival
(4 cycles)
(4 cycles)
Local recurrence rate
FFCD 9203
SS
SS
RR(4 Zyklen)
(4 Zyklen)
Gerard et al. J Clin Oncol 2006, ASCO 2005
Primary endpoint: overall survival
733 patients
TME not routine
Local recurrence rate
EORTC 22921
Bosset et al. N Eng J Med 2006Primary endpoint: overall survival
SS
SS
RR
(4 cycles)
(4 cycles)
1011 patients
SS
SS
(years)0 2 4 6 8 10 12
0
10
20
30
40
50
60
70
80
90
100
Adj. CT vs no Adj CT: p=0.1187
No Adj CT
Adj CT
5-year OS (95%CI)
63.2 (58.3, 68.1)
67.2 (62.7, 71.8)
Disease free survival @ 5 yrs. Overall survival @ 5 yrs.
Bosset et al., NEJM 2006
EORTC Study: Role of adjuvant Chemotherapy
EORTC 22921
Bosset et al. N Eng J Med 2006
Lokal recurrence rate
SS
SS
RR
(4 cycles)
(4 cycles)
1011 patients
SS
SS
TME in 37%
local failurevs.
distant mets. vs.
5y OSvs.
FFCD JCO 2006
RT vs. RChT
16% 8% 36% 38% 66% 67%
EORTC NEJM 2006
RT vs. RChT
17% 9% 32% 35% 65% 65%
AIO/CAO/ARO NEJM 2004
Pre vs. post
13% 6% 36% 38% 74% 76%*
Marijnen ASCO GI 2005
5x5 11% 6% n.a. 63% 64%
PreOP trials: Patterns of failure
Despite significant reduction of local relapse, no influence on distant mets. and survival observed