Adjuvant therapy in colorectal cancer.

Current evidence suggests that there is no role of adjuvant chemotherapy in stage I colon cancer. Patients with stage II colon cancer also do well without any adjuvant therapy with 5 year survivals of upto 80% with surgery alone. However, the role of adjuvant therapy in high risk stage II colon cancer (T4b) needs further evaluation. In stage III colon cancer adjuvant chemotherapy leads to definite survival advantage and is therefore strongly recommended. 5 FU and levamisole given for one year is the standard of care. 5 FU with leucovorin given for six months has shown good results and may become the standard of care in future. In rectal cancer, adjuvant treatment is not recommended for stage I tumours. In patients with stage II & III rectal tumours, a combination of chemotherapy and radiotherapy has given best results.