Adjuvant therapy of colorectal cancer: where do we stand?

The value of adjuvant therapy for colon and rectal cancer has been studied extensively in clinical trials. Data from earlier trials suggested some potential benefit for rectal cancer patients but minimal if any benefit for patients with Dukes' B2, B3 or C colon cancer. More recent data demonstrate that combined irradiation plus chemotherapy is useful in rectal cancer and that postoperative chemotherapy may have a small benefit as adjuvant treatment in patients with adenocarcinoma of the colon. Whether the recently reported statistically significant results in the adjuvant therapy of colon cancer are clinically significant is still being debated. A number of clinical trials evaluating biological response modifiers, regional chemotherapy, and tumor vaccines are either still under way or in the process of evaluation. The results of these trials may significantly enhance the therapeutic options available to clinicians managing patients with resected large bowel cancer.