Is Chemo Needed After Surgery?

Cancer recurrence prediction tool helps determine chemo necessity

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Traditionally, making decisions about whether to operate or treat a cancer with chemotherapy has been a clinical decision by the doctor, with reliance on their own experience and training.

Now, more tools that include worldwide patient data are becoming available to guide doctors.

A recently published tool to analyze patient data for a type of gastrointestinal cancer will help doctors decide whether using chemotherapy for similar patients treatment is necessary. 

The tool calculates the risk of the cancer returning. Use of this model will tell a doctor when surgery alone should be enough to stop the cancer. 

"Ask your oncologist about their use of statistical modeling."

In the study, a team led by Heikki Joensuu, M.D., Ph.D, from Helsinki University Central Hospital in Finland, analyzed data from patients with a particular form of cancer known as gastrointestinal stromal tumor. 

The statistical tool uses risk prediction for each specific patient. It was developed using data from ten studies, involving a total of 2,560 patients. The tool looks at tumor size, growth rate, location, as well as several other variables not found in conventional models.

While many doctors are concerned with preventing recurrence (cancer returning) after surgery, there are also risks to chemotherapy. Effects of chemotherapy range from things like nausea, diarrhea, and fatigue all the way to organ damage.

Having to make the choice between too much chemotherapy and failing to kill the cancer completely is difficult, especially without having solid statistical data to back up the decision. 

Anette Duensing, M.D., from the University of Pittsburgh Cancer Institute, says that mathematical modeling will "ultimately reduce costs and side-effects in patients who are cured by surgery alone, and allow a focus on high-risk patients who need more intense treatment."

Since only about 60 percent of patients would not benefit from additional chemotherapy following surgery, a chief goal of treatment is to medicate only those people who are at risk of recurrence. 

Gastrointestinal stromal tumors are a rare form of cancer that can occur anywhere from the esophagus to the small intestine.

The paper was published in The Lancet Oncology on December 7th, 2011.

The study was funded by the Academy of Finland, the Cancer Society of Finland, the Sigrid Juselius Foundation, as well as Helsinki University Research Funds.

Reviewed by: 
Review Date: 
January 21, 2012
Last Updated:
January 24, 2012