Adjuvant therapy for patients with colorectal cancer

There are now excellent data that patients with stage III colon cancer or stage II and III rectal cancer live longer if they receive, respectively, systemic or regional and systemic therapy after surgery. In addition, disease-free survival, particularly freedom from the symptoms of regional recurrence, in the high risk rectal cancer patient population has been markedly improved by application of multimodality treatment approaches. Newer prospective protocol testing variations in administration of systemic therapy, addition of 5-fluorouracil modulation techniques that proved effective in advanced disease settings, and the combination of therapy attempting to decrease single treatment toxicities while maintaining an antitumor effect have been built on the initial dramatic successes of the past 20 years. This paper concisely summarizes the data that should allow a marked decrease in mortality and morbidity if applied uniformly to patients who remain at high risk for recurrence after surgery for their colon or rectal adenocarcinomas.