The lancet oncology
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The lancet oncology · Jun 2017
ReviewChallenges behind proving efficacy of adjuvant chemotherapy after preoperative chemoradiation for rectal cancer.
For patients with high-risk stage II or stage III colon cancer, adjuvant chemotherapy with fluoropyrimidine monotherapy reduces the risk of recurrence and death by approximately 20-30%. Additional improvements have been reported in three phase 3 colon cancer trials when oxaliplatin was added to fluoropyrimidines, although the effect was mainly on disease-free survival. However, patients with rectal cancer were specifically excluded from these landmark studies because of potential toxicity and the confounding impact of radiotherapy and chemoradiation. ⋯ Consequently, clinical guidelines offer inconsistent recommendations for the management of this patient population. In this Review, we suggest that the available data do not robustly support the routine use of postoperative adjuvant chemotherapy for patients with rectal cancer treated with preoperative chemoradiation. We discuss sources of bias and offer potential reasons to explain this observation, as well as propose a recommended schema for a randomised phase 3 trial that might potentially answer this question definitively.
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The lancet oncology · Jun 2017
Multicenter StudyAdenoma surveillance and colorectal cancer incidence: a retrospective, multicentre, cohort study.
Removal of adenomas reduces colorectal cancer incidence and mortality; however, the benefit of surveillance colonoscopy on colorectal cancer risk remains unclear. We examined heterogeneity in colorectal cancer incidence in intermediate-risk patients and the effect of surveillance on colorectal cancer incidence. ⋯ National Institute for Health Research Health Technology Assessment, Cancer Research UK.
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The lancet oncology · Jun 2017
International incidence of childhood cancer, 2001-10: a population-based registry study.
Cancer is a major cause of death in children worldwide, and the recorded incidence tends to increase with time. Internationally comparable data on childhood cancer incidence in the past two decades are scarce. This study aimed to provide internationally comparable local data on the incidence of childhood cancer to promote research of causes and implementation of childhood cancer control. ⋯ International Agency for Research on Cancer and the Union for International Cancer Control.