open access

Vol 67, No 6 (2017)
Other materials agreed with the Editors
Published online: 2018-05-23
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Should adjuvant therapy be used in patients with colorectal cancer in pathological stage II?

Rafał Stec
DOI: 10.5603/NJO.2017.0062
·
Nowotwory. Journal of Oncology 2017;67(6):375-379.

open access

Vol 67, No 6 (2017)
Short review
Published online: 2018-05-23

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.

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Keywords

colorectal cancer, pathological stage II, adjuvant chemotherapy

About this article
Title

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

Journal

Nowotwory. Journal of Oncology

Issue

Vol 67, No 6 (2017)

Article type

Other materials agreed with the Editors

Pages

375-379

Published online

2018-05-23

DOI

10.5603/NJO.2017.0062

Bibliographic record

Nowotwory. Journal of Oncology 2017;67(6):375-379.

Keywords

colorectal cancer
pathological stage II
adjuvant chemotherapy

Authors

Rafał Stec

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