Not necessarily!
For patients who have received preoperative chemotherapy, the most important factor that physicians consider when choosing a postoperative adjuvant chemotherapy regimen is whether the preoperative chemotherapy regimen is effective.
If the preoperative chemotherapy regimen is effective, physicians will generally continue with the original regimen postoperatively, often with good outcomes as well. Doctors will usually consider a different adjuvant chemotherapy regimen than the preoperative regimen if:
- Post-operative poor health conditions that make it difficult to tolerate the pre-operative regimen, and physicians will usually change to a regimen that has less impact on the body;
- The original regimen has more pronounced side effects, such as bone marrow suppression, neurotoxicity, skin toxicity, etc., and the surgeon may consider reducing the dose or changing the regimen;
- When surgery does not result in radical resection, further treatment options may be selected through multidisciplinary treatment (MDT) discussions.
If preoperative chemotherapy is ineffective or inefficient, for example, if new lesions are identified intraoperatively or lesions that are difficult to manage surgically that were not identified in previous imaging or other tests, different chemotherapy regimens are often applied postoperatively in a targeted manner depending on the situation. (Xin Wang, Department of Gastrointestinal Oncology, The First Hospital of China Medical University, participated in the answer)