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The Optimal Duration of Adjuvant Chemotherapy in Colon Cancer
Review

Adjuvant Chemotherapy for Stage II Colon Cancer

1
Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino of Genova, Largo Rosanna Benzi 10, 16132 Genova, Italy
2
Medical Oncology Unit, Department of Medicine, Surgery and Neurosciences, Azienda Ospedaliera Universitaria Senese, Viale Bracci, 53100 Siena, Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally.
Cancers 2020, 12(9), 2584; https://doi.org/10.3390/cancers12092584
Received: 16 August 2020 / Revised: 4 September 2020 / Accepted: 6 September 2020 / Published: 10 September 2020
(This article belongs to the Special Issue Adjuvant Chemotherapy for Colorectal Cancer)
Stage II colon cancer is defined as an early stage of the tumor disease, without the involvement of lymph nodes or distant organs. In this group of patients, surgery alone is associated with high cure rate and the role of post-operative chemotherapy is still a matter of debate. In patients with tumor features associated with a high risk of recurrence, post-operative chemotherapy is recommended even if it has a small survival benefit. This clinical issue leads to the need for identifying patients who may benefit from post-operative chemotherapy based on their risk of recurrence. The purpose of this review is to highlight and discuss the uncertainties of the previous trials about the risk stratification, the weight of each prognostic factor and the therapeutic benefit of adjuvant chemotherapy in stage II colon cancer patients. Moreover, we summarize the data from previous studies in a decision algorithm that could help clinicians in clinical practice.
In stage II colon cancer management, surgery alone has shown a high cure rate (about 80%), and the role of adjuvant chemotherapy is still a matter of debate. Patients with high-risk features (T4, insufficient nodal sampling, grading, etc.) have a poorer prognosis and, usually, adjuvant chemotherapy is recommended. The purpose of the present study is to highlight and discuss what is still unclear and not completely defined from the previous trials regarding risk stratification and therapeutic benefit of adjuvant chemotherapy. With all the limitations of generalizing, we make the effort of trying to quantify the relative contribution of each prognostic factor and the benefit of adjuvant chemotherapy for stage II colon cancer. Finally, we propose a decision algorithm with the aim of summarizing the current evidence and translating it to clinical practice. View Full-Text
Keywords: stage II colon cancer; adjuvant chemotherapy; risk factor; survival benefit; algorithm stage II colon cancer; adjuvant chemotherapy; risk factor; survival benefit; algorithm
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MDPI and ACS Style

Rebuzzi, S.E.; Pesola, G.; Martelli, V.; Sobrero, A.F. Adjuvant Chemotherapy for Stage II Colon Cancer. Cancers 2020, 12, 2584. https://doi.org/10.3390/cancers12092584

AMA Style

Rebuzzi SE, Pesola G, Martelli V, Sobrero AF. Adjuvant Chemotherapy for Stage II Colon Cancer. Cancers. 2020; 12(9):2584. https://doi.org/10.3390/cancers12092584

Chicago/Turabian Style

Rebuzzi, Sara E., Guido Pesola, Valentino Martelli, and Alberto F. Sobrero. 2020. "Adjuvant Chemotherapy for Stage II Colon Cancer" Cancers 12, no. 9: 2584. https://doi.org/10.3390/cancers12092584

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