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Adjuvant treatment of stage III colon cancers: News and perspectives Volume 27, issue 6, Juin 2020

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Authors
CHU de Poitiers, service d’hépato-gastro-entérologie, 2 rue de la Milétrie, 86000 Poitiers Cedex
* Correspondance

When a colon cancer with nodal invasion (stage III colon cancer) is diagnosed upon histological examination, the five-year risk of recurrence is over 50%. Adjuvant chemotherapy must start within six weeks after surgery. The standard protocol combining a fluoropyrimidin (5-Fluoro-uracil or capecitabine) with oxaliplatin (FOLFOX or XELOX) every two weeks during six months is recommended. FOLFOX during six months is validated for patients below 70 years old with high risk of recurrence tumour (pT4 and/or N2). For patients with low risk tumours (pT1-3 N1), XELOX protocol every three weeks during three months is an option as it reduces neurotoxicity without increasing the risk of recurrence. Patients over 70 years old form a distinct and heterogenous population for whom few data are available. For unfit patients, a LV5FU2 protocol every two weeks during six months is recommended. New criteria to determine precisely the risk of recurrence, such as immunological scores and molecular signatures, are emerging.