Adjuvant systemic chemotherapy for XXXX after complete resection: an updated practice guideline.

@entity901 @entity1 @entity2600 @entity416 @entity5 @entity1820 @entity694 @entity1487
AIMS: The standard adjuvant therapy for resected @entity5 has been intravenous @entity1487 . However, newer chemotherapy agents, such as @entity416 , @entity901 and @entity2600 , have been investigated in clinical trials since the publication of the original guidelines. The @entity1820 Site Group (DSG) conducted a systematic review of the evidence for the use of adjuvant systemic chemotherapy for @entity1 with resected stage II and III @entity694 and developed an updated practice guideline based on that evidence and expert consensus. The following research questions were addressed: Should @entity1 with @entity5 receive adjuvant systemic chemotherapy? What are the preferred adjuvant systemic chemotherapy options for @entity1 with completely resected @entity5 ? Outcomes of interest were disease-free survival, overall survival, adverse effects and quality of life. MATERIALS AND METHODS: A systematic search of published studies was conducted for the time period following the publication of the original guidelines to identify relevant randomised trials and syntheses of evidence in the form of meta-analyses. Recommendations were based on that evidence, evidence contained in the original guidelines and consensus of the @entity1820 DSG. The systematic review and practice guideline were externally reviewed through a mailed survey of practitioners in Ontario, Canada. RESULTS: Recommendations were drafted based on the available evidence and expert consensus. CONCLUSIONS: The routine use of adjuvant chemotherapy for all @entity1 with @entity5 is not recommended. However, a subset of @entity1 with high-risk stage II disease should be considered for adjuvant therapy. @entity1 with completely resected @entity5 should be offered adjuvant chemotherapy. Treatment should depend on factors such as @entity1 suitability and preference, and @entity1 and clinicians must work together to determine the optimal course of treatment.
