Abstract
The adjuvant treatment of patients with stage II colon cancer is an area of controversy
in medical oncology. Adjuvant chemotherapy aims to eradicate micrometastatic disease
present at the time of surgery, preventing the development of distant metastatic disease
and thereby curing those patients of their cancer. National and international guidelines
for the adjuvant treatment of stage II colon cancer recommend a range of treatment
options from observation to chemotherapy with single-agent or combination regimens,
depending on the presence or absence of high-risk features (poorly differentiated
histology, presence of lymphovascular invasion, presence of perineural invasion, report
of < 12 lymph nodes, bowel obstruction, localized perforation, or positive margins).
In the one prospective study designed to address the role of adjuvant chemotherapy
in stage II colon cancer, a small but statistically significant benefit in overall
survival was seen for those patients who received adjuvant chemotherapy; however,
multiple meta-analyses and retrospective subgroup analyses have called these findings
into question. Though there may be a role for adjuvant chemotherapy in the treatment
of patients with stage II colon cancer, its incremental benefit is small, at best,
and comes with the risks of real and rarely fatal complications of chemotherapy.
Keywords stage II colon cancer - adjuvant therapy - chemotherapy
