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Should adjuvant therapy be used in patients with colorectal cancer in pathological stage II?
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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.
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.
Keywords
colorectal cancer, pathological stage II, adjuvant chemotherapy
About this articleTitle
Should adjuvant therapy be used in patients with colorectal cancer in pathological stage II?
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Other materials agreed with the Editors
Pages
375-379
Published online
2018-05-23
Page views
619
Article views/downloads
663
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2017;67(6):375-379.
Keywords
colorectal cancer
pathological stage II
adjuvant chemotherapy
Authors
Rafał Stec