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Recent Advances in the Treatment of Colorectal Cancer pp 81–100Cite as

Adjuvant Chemotherapy

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Abstract

Recent remarkable advances in chemotherapy for colorectal cancer are adding new knowledge to adjuvant chemotherapy, but it is not the case that recurrence can be prevented in all patients who undergo this treatment. Treatment should be selected based on the evidence from clinical trials. Herein we present a review of the development of systemic chemotherapy for colorectal cancer (CRC) in the adjuvant treatment settings.

Adjuvant treatment with a fluoropyrimidine plus oxaliplatin has been the standard of care for resected stage III colon cancer. It has been suggested that stage III CRC consists of subgroups of patients with various prognoses and the expected benefits of L-OHP could vary according to subgroup stage. Oral fluoropyrimidine alone treatment might be a considerable option for low-risk patients. Adjuvant treatment for elderly patients who have formerly been excluded from clinical trials must be considered. Although the usefulness of adjuvant chemotherapy for stage II colon cancer remains controversial, guidelines recommend adjuvant chemotherapy for patients with high-risk features.

In rectal cancer, the efficacy of adjuvant chemotherapy has not been established. Although conclusive evidence of the benefits of adjuvant therapy in patients with rectal cancer is unclear, adjuvant chemotherapy is recommended for patients with stage II and stage III rectal cancer.

For resectable metastatic disease, there is no standard treatment and the effective role of systemic adjuvant chemotherapy remains controversial. However, the current international guidelines recommend an adjuvant treatment for patients with initially resectable metastatic disease.

It is necessary to establish the optimal adjuvant chemotherapy corresponding to the conditions of individual patients.

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  1. Department of Specialized Surgeries, Tokyo Medical and Dental University, Graduate School of Medicine and Dentistry, Tokyo, Japan

    Toshiaki Ishikawa & Hiroyuki Uetake

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  1. Toshiaki Ishikawa
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  2. Hiroyuki Uetake
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Correspondence to Toshiaki Ishikawa .

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  1. Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan

    Hideyuki Ishida

  2. Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan

    Keiji Koda

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Ishikawa, T., Uetake, H. (2019). Adjuvant Chemotherapy. In: Ishida, H., Koda, K. (eds) Recent Advances in the Treatment of Colorectal Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-13-3050-6_8

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