Less Radiotherapy Improves Survival in Low-Risk Rectal Cancer

In a cross-sectional study of 2775 patients with colorectal cancer from 2011 to 2016, decreased use of neoadjuvant radiotherapy (87% to 37%) was not associated with changes in 4-year local recurrence (5.8% vs 5.5%) in patients with lower risk rectal cancers (cT1-3, N0-1, MRF-). However, the decrease in neoadjuvant radiotherapy was associated with a significant improvement in 4-year overall survival, increasing from 79.6% to 86.4% (p < 0.001).

These findings from the article published in Jama Oncology indicate that with the routine use of magnetic resonance imaging and the continued improvement of the quality of rectal cancer surgery, neoadjuvant therapy may be safely omitted for most cases of localised rectal cancer.