[Colorectal cancers: adjuvant therapy and after care (including tumor markers)]

Perioperative adjuvant treatment after radical surgery for colorectal cancer has proven to be possible without an increase of postoperative complications and postoperative mortality. In overcoming this surgical fear, a number of randomized studies, all of them investigating the role of adjuvant treatment, have been initiated. Preliminary results of these trials show, some of them already statistically significant, an advantage of the adjuvant treated patient group. Unless these results have been confirmed, adjuvant treatment should only be given in well designed, randomized clinical trials. Only these trials can prove the effectiveness of adjuvant therapy in radical surgery of colorectal neoplasms. In addition, these studies should be used to define the group of patients who really benefit of adjuvant treatment. The main goal of follow up methods after surgery for colorectal cancer should be the detection of asymptomatic and still treatable tumor recurrences. For this reason, frequent clinical investigations and frequent CEA level determinations seem to be the most important components at this time.