Does adjuvant fluoropyrimidine-based chemotherapy provide a benefit for patients with resected rectal cancer who have already received neoadjuvant radiochemotherapy? A systematic review of randomised trials.

Summary: Imagine you have been diagnosed with rectal cancer. Standard treatment often involves radiation and chemotherapy before surgery to shrink the tumor, followed by the surgery itself. For years, guidelines have suggested adding more chemotherapy after the surgery (adjuvant chemotherapy) to be safe. But does this extra step actually help?

A systematic review of four major randomized trials suggests the answer is likely "no." Researchers found that for patients who already had treatment before surgery, adding more chemotherapy afterward did not improve survival rates compared to simply being monitored. While there might be exceptions for specific subgroups, the evidence indicates that for most patients, this extra chemotherapy offers no clear benefit and may simply expose them to unnecessary side effects and "over-treatment."