CAO/ARO/AIO-94 (German Rectal Cancer Study)
The German rectal trial moved chemoradiation to before surgery: local recurrence halved, more sphincters were saved and toxicity fell, with survival unchanged.
Overview
CAO/ARO/AIO-94 randomised 823 patients with clinical stage II or III rectal cancer to fluorouracil-based chemoradiation (50.4 Gy) given before or after total mesorectal excision. Five-year local recurrence was 6 percent with preoperative and 13 percent with postoperative treatment; acute and long-term toxicity were lower, and sphincter preservation in low tumours doubled, with no difference in overall survival (Sauer and colleagues, New England Journal of Medicine 2004). Preoperative chemoradiation became the standard for locally advanced rectal cancer.
- 6 vs 13 out of 100 reached this endpoint at 5 years with Preoperative chemoradiation compared with Postoperative chemoradiation; 7 fewer per 100.
- On this measure the first group did worse, not better.
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- These results apply to the people the trial enrolled: Locally advanced rectal cancer: preoperative versus postoperative fluorouracil chemoradiation. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
823 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Local recurrence at 5 yearsprimary | Preoperative chemoradiation | 421 | 6% | - | - | - |
| Postoperative chemoradiation | 402 | 13% |
Similar pages
not linked directly; found by shared links- TrialINT-0116 (Macdonald trial)
Shares Chemoradiation (chemoradiotherapy, CRT), Fluorouracil (5-FU), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
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- TrialDe-ESCALaTE HPV
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- TrialRAPIDO
Shares IMRT / IGRT (modern external beam), Colorectal cancer and the tag radiation-wave4.
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Shares Fluorouracil (5-FU), IMRT / IGRT (modern external beam) and the tag radiation-wave4.