It can improve quality of care and offer modest increases in survival

Papers p 531

Colorectal cancer is the second most common cause of death from cancer in industrialised countries. Despite intensive investigations over the past decade, there has been no improvement in the long term prognosis of most patients with advanced disease. These patients have an estimated five year survival rate of 5% (excluding the comparatively small number of patients who have disease limited to the liver, which is suitable for surgical resection or ablative techniques).1 Outcomes depend on a variety of factors, such as physical functioning and the tumour burden. Until recently, the role of chemotherapy as palliative treatment in advanced colorectal cancer has been questioned. However, the report from the Colorectal Cancer Collaborative Group in this week's journal (p 531) essentially confirms the role of chemotherapy in improving both the survival and the quality of life of patients with advanced colorectal cancer.2

The group's report looks at the results of a systematic review and meta-analysis of randomised trials that compared chemotherapy with best supportive care in patients with advanced colorectal cancer. The analysis was based on data from individual patients, and if these were not available published summary statistics were used.2 The main end points were survival, disease progression, quality of life, drug toxicity, …