New approaches to the adjuvant therapy of colon cancer.
Analysis of data from patients treated outside clinical trials suggests that adjuvant chemotherapy for stage II colon cancer provides less than a 3% absolute improvement in survival at 5 years. This is remarkably close to the small degree of benefit suggested by controlled studies. An overview of the data suggests that surgery alone cures approximately 75% of stage II patients. Between 20% and 25% of patients experience disease recurrence despite surgery and adjuvant chemotherapy, whereas adjuvant chemotherapy cures between 1% and 6%. In stage III patients, the benefit of adjuvant therapy is greater overall. The extent of benefit relates to tumor grade, invasion, and nodal involvement. Incorporation of molecular markers in the design of current trials may enable us to refine our identification of patients at highest risk of recurrence and hence those standing to gain most from adjuvant therapy.
Benson
Al B
AB
Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Division of Hematology/Oncology, 676 N. St. Clair, Suite 850, Chicago, Illinois 60611, USA. a-benson@northwestern.edu
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D006801:Humans; D018714:Radiotherapy, Adjuvant
D014408:Biomarkers, Tumor