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October 25, 1976

Fluorouracil as an Adjuvant to Colorectal Cancer Surgery; The Breakthrough That Never Was

Author Affiliations

Rochester, Minn

JAMA. 1976;236(17):1935-1936. doi:10.1001/jama.1976.03270180013003

To the Editor.—  In an article published in The Journal (235:2825, 1976) that was endorsed by an editorial, Li and Ross claimed "a significant improvement of five-year cure rate" for patients with type B and C Dukes colorectal cancer through the use of fluorouracil as a surgical adjuvant. The Journal editorial would appear to offer enthusiastic concurrence: "Li and Ross show clearly the benefit from two postoperative courses of fluorouracil in patients with colorectal carcinoma," and "One of the striking features... is the exceptionally short duration of treatment with fluorouracil necessary to achieve the impressive results." It is scarcely surprising that such outspoken claims made "breakthrough" headlines in the news media. These claims have no foundation in fact.Li and Ross have attempted to demonstrate the effectiveness of fluorouracil as a surgical adjuvant by comparing survivorship in patients so treated from 1965 to 1970 with survivorship in patients treated with