According to a comment article, the results are interesting but not definitive as they come from a phase II study. In addition, 3-year disease-free survival in fluorouracil plus leucovorin group was lower than expected, which might have resulted in an overestimation of absolute difference in 3-year disease-free survival. The commentators note the substantial variability in diagnosis and treatment approaches for rectal cancer between western and Asian countries, which negatively affects the ability to extrapolate trial results from Asian patients to western patients, and vice versa. They suggest that based on the results of the ADORE trial, “adjuvant FOLFOX should not be regarded as a standard of care for patients with postoperative pathological stage II or III rectal cancer in western countries. In the South Korean population investigated in the ADORE trial, adjuvant FOLFOX seems to be beneficial over fluorouracil plus leucovorin. Nevertheless, existing evidence does not support the routine use of adjuvant chemotherapy for patients with rectal cancer treated with preoperative radiotherapy or chemoradiotherapy and total mesorectal excision, and further investigation is warranted.”