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November 9, 1984

Adjuvant Chemotherapy: Eight Years Later

Author Affiliations

From the Division of Oncology, the University of Massachusetts Medical School/Center, Worcester.

JAMA. 1984;252(18):2611-2612. doi:10.1001/jama.1984.03350180065034

JUST a little over eight years ago I expressed my concerns1 about the uncritical and premature acceptance of the results of the then recently published adjuvant study by the National Surgical Breast Project (NSABP).2 The NSABP report detailed early results of a randomized study of patients who had undergone mastectomy with axillary lymph nodes treated either with phenylalanine or placebo. The publication created tremendous excitement and enthusiasm, both in the medical community and in the press. There were those who believed that the cure of cancer was just around the corner,3 and others who believed that the whole matter was greatly overexaggerated.4 Now, eight years later, we have seen innumerable reports of studies utilizing adjuvant chemotherapy, principally in the treatment of stage II breast cancer, but also in other tumors, such as gastric, melanoma, and colon cancer. Several things have become obvious over the intervening years. On