The FOXTROT trial examined the role of neoadjuvant FOLFOX chemotherapy in colon cancer. Compared to upfront surgery, neoadjuvant chemotherapy resulted in:
- A Significant improvement in 2-year overall survival
- B Higher rate of complete pathological response in T4 tumours
- C Reduced incomplete resection rate and down-staging with acceptable toxicity ✓
- D Increased anastomotic leak rate due to chemotherapy-induced immunosuppression
Correct answer: C. Reduced incomplete resection rate and down-staging with acceptable toxicity
Explanation
The FOXTROT trial showed that 6 weeks of neoadjuvant FOLFOX for locally advanced colon cancer reduced incomplete (R1/R2) resection rates from 14% to 4%, achieved down-staging in a significant proportion, and had acceptable surgical complication rates. Overall survival data at the time of publication was not yet mature. It did not increase anastomotic leak rates significantly.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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