Adjuvant therapy of colorectal cancer.

Abstract

This review was undertaken to examine the evidence of the effectiveness of adjuvant chemotherapy in colorectal cancer. Published studies were reviewed and analyzed. For over three decades, a large series of adjuvant systemic trials have been conducted in carcinoma of the colon and rectum in an attempt to reduce recurrence and ultimately improve survival. However, only in the last few years have significant gains been made. In colon cancer with regional nodal metastasis, combined treatment with 5-fluorouracil and levamisole has resulted in significant reduction of tumor recurrence and improved survival. In rectal cancer, combined modality treatment with radiotherapy and chemotherapy is considered the standard for care by many investigators, although numerous questions remain unanswered. The existing evidence suggests that adjuvant therapy may be of value in selected patients with colorectal cancer. Several currently active trials are pursuing very hopeful leads, and clinicians are encouraged to enter their patients on available trials.