Gabriel et al1 have concluded that there are patients who, by current treatment guidelines, would likely receive preoperative chemoradiation who may not require it. It may be appropriate to state (although this is beyond their conclusions) that the additional unnecessary therapy may be harmful, as the FFCD 9901 trial concluded.2 Studies like these that identify subgroups of patients less likely to benefit from multimodality therapy are useful in avoiding overtreatment of patients.
Hofstetter WL. Preoperative Chemoradiation in an Era of Suboptimal Clinical Staging. JAMA Surg. 2016;151(3):245-246. doi:10.1001/jamasurg.2015.4047