CHU Dijon, Service d’hépato-gastroentérologie et oncologie digestive, Dijon
EPICAD INSERM LNC-UMR 1231, Université de Bourgogne et Franche Comté, Dijon
In 2021, before prescribing adjuvant chemotherapy after resection for cure for colon cancer, clinicians must consider physiological age of the patient and verify the absence of dihydroprimidine deshydrogénase deficiency. For stage II colon cancers, adjuvant chemotherapy is not considered as a standard. It could be discussed individually in a multidisciplinary concertation meeting in some situations, such as stage T4, perforation or occlusion, number of lymph nodes examined <12, poorly differentiated and/or mucoid tumor, lymphatic, venous or peri-nervous invasion. Factors contra for adjuvant chemotherapy are microsatellite instability, age and patient refusal. For low-risk stage III (T1-3 N1) tumors, chemotherapy with CAPOX (capecitabine + oxaliplatine) during 3 months should be preferred. For high-risk Stage III (T4 and/or N2): chemotherapy with FOLFOX (5-FU + oxaliplatine) during 6 months is recommended.