Does the addition of induction chemotherapy improve outcome in locally advanced rectal carcinoma?

Locally advanced rectal cancer (LARC) is defined as directly tumor invasion into the pericolorectal tissues (T3) and other organs or structures (T4), and/or metastasis in regional lymph node (N+). The treatment of LARC is multidisciplinary, and neo-adjuvant chemoradiotherapy (CRT) followed by surgery is the standard of care in this setting of patients, based on the CAO/ARO/AIO-94 German Rectal Cancer Study. This study compared neo-adjuvant versus adjuvant CRT regimen in a cohort of 823 patients with LARC. Neo-adjuvant CRT improved local control (6 versus 13 %, p=0.02), as well as sphincter preservation (39 versus 19 %, p=0.004) and decreased acute and late toxicity (27 versus 40 % and 14 versus 24 %, respectively) compared with post-operative CRT