[What's new in adjuvant therapy of colorectal cancers?]

The indication for adjuvant chemotherapy after macroscopically complete resection of a colonic cancer with lymph node involvement (Dukes C or stage III) is now established. Ongoing studies are designed to define the optimal modalities. A 6-month postoperative treatment based on 5-FU modulated by folinic acid currently represents standard treatment, as conventional treatment with 5-FU and Levamisole for one year is more constraining, potentially more toxic and not more effective. No published study has yet demonstrated any significant benefit of adjuvant chemotherapy for forms B2 or II, essentially because of a lack of statistical power. The place of local treatment and specific immunotherapy is currently being investigated. In the short- or medium-term, the development of new drugs active in the metastatic setting, as well as genetic prognostic factors, should modify current attitudes concerning indications and modalities of adjuvant chemotherapy for colonic cancers.