ADJUVANT THERAPY FOR COLON AND RECTAL-CANCER

Newly diagnosed colon or rectal cancer should be staged using the TNM (tumor, node and distant metastasis) nomenclature to determine prognos tic factors. Based on this staging, it is possible to select patients in need of adjuvant therapy following surgery. In patients with stage III colon cancer, adjuvant chemotherapy with fluorouracil and levamiso le has been shown to produce a 40 percent reduction in the recurrence rate at a median follow-up of 6.5 years as well as a 33 percent reduct ion in mortality. Adjuvant chemotherapy should be considered in all pa tients with stage III colon cancer and in selected patients with high- risk stage II colon cancer. A 34 percent improvement in disease-free i nterval and a 29 percent improvement in survival have been reported fo r patients receiving fluorouracil, methyl-CCNU and radiotherapy. Adjuv ant chemotherapy and radiotherapy are indicated in patients with stage s II and III rectal cancers.