INTRODUCTION: There remains a lack of high quality randomised trial evidence for the use of adjuvant chemotherapy in stage II rectal cancer, particularly in the presence of high risk features such as extramural venous invasion (EMVI). The aim of this study was to explore this issue through a survey of colorectal surgeons and gastrointestinal oncologists. METHODS: An electronic survey was sent to a group of colorectal surgeons who were members of the Association of Coloproctology of Great Britain and Ireland. The survey was also sent to a group of gastrointestinal oncologists through the Pelican Cancer Foundation. Reminder emails were sent at 4 and 12 weeks. RESULTS: A total of 142 surgeons (54% response rate) and 99 oncologists (68% response rate) responded to the survey. The majority in both groups of clinicians thought EMVI was an important consideration in adjuvant treatment decision making and commented routinely on this in their multidisciplinary team meeting. Although both would consider treating patients on the basis of EMVI detected by magnetic resonance imaging, oncologists were more selective. Both surgeons and oncologists were prepared to offer patients with EMVI adjuvant chemotherapy but there was lack of consensus on the benefit. CONCLUSIONS: This survey reinforces the evolution in thinking with regard to adjuvant therapy in stage II disease. Factors such as EMVI should be given due consideration and the prognostic information we offer patients must be more accurate. Historical data may not accurately reflect today's practice and it may be time to consider an appropriately designed trial to address this contentious issue.
INTRODUCTION: There remains a lack of high quality randomised trial evidence for the use of adjuvant chemotherapy in stage II rectal cancer, particularly in the presence of high risk features such as extramural venous invasion (EMVI). The aim of this study was to explore this issue through a survey of colorectal surgeons and gastrointestinal oncologists. METHODS: An electronic survey was sent to a group of colorectal surgeons who were members of the Association of Coloproctology of Great Britain and Ireland. The survey was also sent to a group of gastrointestinal oncologists through the Pelican Cancer Foundation. Reminder emails were sent at 4 and 12 weeks. RESULTS: A total of 142 surgeons (54% response rate) and 99 oncologists (68% response rate) responded to the survey. The majority in both groups of clinicians thought EMVI was an important consideration in adjuvant treatment decision making and commented routinely on this in their multidisciplinary team meeting. Although both would consider treating patients on the basis of EMVI detected by magnetic resonance imaging, oncologists were more selective. Both surgeons and oncologists were prepared to offer patients with EMVI adjuvant chemotherapy but there was lack of consensus on the benefit. CONCLUSIONS: This survey reinforces the evolution in thinking with regard to adjuvant therapy in stage II disease. Factors such as EMVI should be given due consideration and the prognostic information we offer patients must be more accurate. Historical data may not accurately reflect today's practice and it may be time to consider an appropriately designed trial to address this contentious issue.
Authors: Oliver C Shihab; Fiona Taylor; Gisella Salerno; Richard J Heald; Philip Quirke; Brendan J Moran; Gina Brown Journal: Ann Surg Oncol Date: 2011-05-18 Impact factor: 5.344
Authors: B Fisher; N Wolmark; H Rockette; C Redmond; M Deutsch; D L Wickerham; E R Fisher; R Caplan; J Jones; H Lerner Journal: J Natl Cancer Inst Date: 1988-03-02 Impact factor: 13.506
Authors: Muhammed R S Siddiqui; Constantinos Simillis; Chris Hunter; Manish Chand; Jemma Bhoday; Aurelie Garant; Te Vuong; Giovanni Artho; Shahnawaz Rasheed; Paris Tekkis; Al-Mutaz Abulafi; Gina Brown Journal: Br J Cancer Date: 2017-04-27 Impact factor: 7.640
Authors: Akitoshi Inoue; Shannon P Sheedy; Jay P Heiken; Payam Mohammadinejad; Rondell P Graham; Hee Eun Lee; Scott R Kelley; Stephanie L Hansel; David H Bruining; Jeff L Fidler; Joel G Fletcher Journal: Insights Imaging Date: 2021-08-09