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Invited Critique
November 17, 2008

Cyclooxygenase-2 Expression in Pretreatment Biopsy as a Predictor of Tumor Responses After Preoperative Chemoradiation in Rectal Cancer—Invited Critique

Arch Surg. 2008;143(11):1097. doi:10.1001/archsurg.143.11.1097

Min et al from Seoul nicely show that the expression of COX-2 protein in colon cancer specimens inversely correlates with the tumor's response to adjuvant CRT. While I cannot tell if this is really a prospective study or a retrospective analysis of 30 consecutive patients with stage II and III disease, it is work that pushes the envelope of diagnostic tests to the next—molecular—level.

It has been 10 years since the landmark Swedish study demonstrated that preoperative adjuvant CRT improved survival in rectal cancer.1 The authors are currently asking which patients will really benefit from the therapy. The answer will be at the molecular level.

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