In the Dutch TME trial, total mesorectal excision (TME) combined with preoperative short-course radiotherapy (5×5 Gy) compared to TME surgery alone demonstrated the primary benefit of:

• A Significant improvement in overall 10-year survival
• B Reduced requirement for permanent colostomy
• C Increased pathological complete response rates
• D Significant reduction in local recurrence rates at 10 years ✓

Explanation

The Dutch Colorectal Cancer Group TME trial showed that preoperative short-course radiotherapy (25 Gy in 5 fractions) before TME surgery reduced the 10-year local recurrence rate from 11% to 5% in resectable rectal cancer, without a significant improvement in overall survival. This establishes that the primary benefit of short-course RT is locoregional control. Pathological complete response is more associated with long-course chemoradiotherapy, not short-course RT. Colostomy rates are determined by tumor level, not radiotherapy.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.