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The UK trial that measured exactly how small the benefit of chemotherapy is after surgery for early bowel cancer, turning a default into a conversation.
QUASAR asked whether chemotherapy helps people whose bowel cancer was removed but whose risk of recurrence is low, the group for whom the answer had been guesswork. It randomised 3,239 people, nine in ten with stage II disease, to fluorouracil with folinic acid or to observation with chemotherapy held in reserve for recurrence. After a median 5.5 years the relative risk of death was 0.82 (95 percent confidence interval 0.70 to 0.95, p = 0.008) and of recurrence 0.78 (0.67 to 0.91, p = 0.001), with no significant difference by tumour site, stage, sex, age or schedule. The authors translated that into the number that mattered: assuming 20 percent five-year mortality without chemotherapy, an absolute survival gain of about 3.6 percent (1.0 to 6.0).
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.
Shares Rachel Kerr, Oxford Cancer (Oxford University Hospitals and University of Oxford), Neoadjuvant / adjuvant / perioperative, Colon cancer (adenocarcinoma of the colon) and the tags uk, adjuvant, colorectal.
Shares Rachel Kerr, Oxford Cancer (Oxford University Hospitals and University of Oxford), Colorectal cancer and the tags uk, colorectal.
Shares Neoadjuvant / adjuvant / perioperative, Fluorouracil (5-FU), Colon cancer (adenocarcinoma of the colon), Cytotoxic chemotherapy and the tags uk, colorectal.
Shares Oxford Cancer (Oxford University Hospitals and University of Oxford), Colorectal cancer and the tags uk, colorectal.
Shares MRC Clinical Trials Unit at UCL, Leucovorin (folinic acid), Fluorouracil (5-FU), Colorectal cancer.
Shares Leucovorin (folinic acid), Neoadjuvant / adjuvant / perioperative, Fluorouracil (5-FU), Colon cancer (adenocarcinoma of the colon).
Shares Colorectal cancer and the tags uk, colorectal.
Shares Cytotoxic chemotherapy, Colorectal cancer and the tags adjuvant, colorectal.