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Adjuvant Treatment of Colon and Rectal Cancer: Impact of Chemotherapy, Radiotherapy, and Immunotherapy on Routine Postsurgical Patient Management

  • Conference paper
New Perspectives in Molecular and Clinical Management of Gastrointestinal Tumors

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 142))

Abstract

Colon cancer patients with UICC stage III or T4 N0 M0 stage II should receive postoperative adjuvant therapy, since relapse rates are high and surgical outcome has been improved by adjuvant treatment. The standard treatment is 5-fluourouracil plus levamisole; an alternative option is the combination of 5-fluourouracil and folinic acid. Stage II (T3 N0 M0) colon cancer patients should not receive adjuvant treatment outside of studies.Rectal cancer patients of stage II or III should receive postoperative radiochemotherapy with 45–54.4 Gy and 5-fluourouracil as standard treatment. Patients not eligible for radiotherapy may receive adjuvant chemotherapy only. Studies need to be conducted to improve adjuvant therapy in colorectal cancer. All qualified patients should be treated within these studies requiring sufficient patient numbers, as well as comparable surgical procedures, proper patient selection and stratification criteria, drug and dose intensities.

Intraportal infusion may be as effective as systemic adjuvant treatment; the tumor type and stage for which benefit from this kind of treatment is consistently significant needs to be defined, since intraportal infusion of all resectable colorectal cancers is overtreatment.

Both surgery and histopathological staging may be improved in some centers, and these require standardization and quality control.

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Authors and Affiliations

  1. Department of General Surgery, University Hospital of Ulm, Steinhövelstraße 9, 89075, Ulm, Germany

    K. H. Link, L. Staib & H. G. Beger

  2. Department of Hematology and Oncology, Benjamin Franklin University, Hindenburgdamm 30, 12200, Berlin, Germany

    E.-D. Kreuser

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  1. K. H. Link
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  2. L. Staib
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  3. E.-D. Kreuser
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  4. H. G. Beger
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  1. Fachbereich Humanmedizin, Univ.-Klinikum Benjamin Franklin, Medizinische Klinik und Poliklinik, Schwerpunkt Hämatologie und Onkologie, Freie Universität Berlin, Hindenburgdamm 30, 12200, Berlin, Germany

    Ernst-D. Kreuser

  2. Robert-Rössle Klinik am Max-Delbrück-Centrum, Humboldt-Universität, Lindenberger Weg 80, 13122, Berlin, Germany

    P. M. Schlag

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Link, K.H., Staib, L., Kreuser, ED., Beger, H.G. (1996). Adjuvant Treatment of Colon and Rectal Cancer: Impact of Chemotherapy, Radiotherapy, and Immunotherapy on Routine Postsurgical Patient Management. In: Kreuser, ED., Schlag, P.M. (eds) New Perspectives in Molecular and Clinical Management of Gastrointestinal Tumors. Recent Results in Cancer Research, vol 142. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80035-1_19

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