Colorectal cancer: chemotherapy as surgical adjuvant treatment.

As we view our past accomplishments in chemotherapy of colorectal cancer, it would seem clear that none of our approaches for any stage of this disease can be regarded as optimal for clinical practice or even as having any established benefit. The use of chemotherapy in the routine clinical practice setting for this disease provides little or no value to the patient today and is a distinct disservice to the patient of tomorrow. Nevertheless, the failure of past accomplishment should not lead to therapeutic nihilism. The major human problem which this disease presents demands intensive and sophisticated clinical research efforts. It would also seem obvious that these efforts require coordination of all concerned disciplines. Such a team effort should include not only the surgeon, medical oncologist, and the radiation therapist but also the laboratory scientist. With integrated and concentrated effort, a foundation can be laid for realistic optimism regarding improvement in therapy for colorectal cancer in the years immediately ahead.