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Adjuvant Systemic Chemotherapy for Stage II and III Colon Cancer Following Complete Resection

Version: 2 ID: 2-29 Sep 2014
Type of Content: Guidelines & Advice, Clinical
Document Status: In-Review
Authors:
B. Meyers, R. Cosby, F. Quereshy, D. Jonker, Gastrointestinal Disease Site Group

Guideline Objective

To make recommendations with respect to the role of adjuvant systemic chemotherapy in stage II and III colon cancer patients who have undergone complete resection with curative intent.

Patient Population

Adult patients with stage II and III colon cancer who have undergone complete resection with curative intent as primary therapy.

Intended Guideline Users

Clinicians involved in the delivery of adjuvant systemic chemotherapy for stage II and III colon cancer patients.

Research Question(s)

  1. What is the impact of adjuvant fluoropyrimidine-based systemic chemotherapy versus observation on disease-free survival (DFS) and OS in patients with stage II or III colon cancer who have undergone complete resection with curative intent?
  2. What is the impact of adjuvant intravenous (IV) 5-FU versus oral fluoropyrimidines on DFS and OS in patients with stage II or III colon cancer who have undergone complete resection with curative intent?
  3. a) What is the impact of adjuvant fluoropyrimidines versus fluoropyrimidines plus oxaliplatin on DFS and OS in patients with:
    1. stage II or III colon cancer who have undergone complete resection with curative intent?
    2. stage II colon cancer who have undergone complete resection with curative intent?
    3. stage III colon cancer who have undergone complete resection with curative intent?
  1. b) What is the impact on DFS and OS of the addition of oxaliplatin to fluoropyrimidine-based adjuvant chemotherapy in patients with stage II or III colon cancer who have undergone complete resection with curative intent?
  2. a) What is the impact of the addition of oxaliplatin to fluoropyrimidine-based adjuvant chemotherapy, on DFS and OS, in younger versus older (≤70 years versus >70 years) stage II or III colon cancer patients who have undergone complete resection with curative intent?
  1. b) What is the impact of adjuvant fluoropyrimidine monotherapy, on DFS and OS, in younger versus older (≤70 years versus >70 years) stage II or III colon cancer patients who have undergone complete resection with curative intent?
  2. What is the impact of microsatellite instabilty status on DFS and OS with the addition of adjuvant chemotherapy in stage II patients with colon cancer who have undergone complete resection with curative intent?
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