Should adjuvant therapy be used in patients with colorectal cancer in pathological stage II?

Abstract

In meta-analyses and reliable randomised clinical trials, the most favourable therapeutic gain of adjuvant therapy of patients with colorectal cancer in stage II was estimated at 3% (in the majority of meta-analyses no statistical significance was). Considering the side effects, especially the mortality rate in chemotherapy (FOLFOX reached 0.5%, and in the case of 5-fluorouracil, the occurrence of toxicity grade 3 and 4, increased the risk of patient death by approximately 1%) seems to be questionable. Because of the lack confirmation of the effect of systemic treatment, an
increase of the percentage of cured patients in the second stage has led to the development of several genetic tests determining the genetic signature of colorectal cancer. The aim of these tests is to identify the groups of patients that could potentially achieve the greatest benefit from adjuvant therapy. The most important tests are: “Oncotype DX”, “ColoPrint” and “GeneFx”. However, at the moment, there is no clear scientific evidence in favour of the standard use of adjuvant chemotherapy in patients with colon cancer in stage II.