Why we should not treat patients with stage II colon cancer

Research assessing the worth of adjuvant chemotherapy for stage II colon cancer has been ongoing for several decades. The majority of studies have not demonstrated a significant improvement in survival. Despite this, many patients with stage II disease deemed to be at high-risk for recurrence do receive postoperative chemotherapy. The benefit of adjuvant therapy in such high-risk patients has been suggested by retrospective analyses of phase III trials. Molecular and genetic factors are being investigated to learn if they can predict those who might benefit most from adjuvant therapy. The results of randomized trials and pooled analyses will be reviewed to argue that the majority of stage II colon cancer patients should not receive adjuvant chemotherapy. Prospective studies addressing the benefit of adjuvant chemotherapy in high-risk patients are a high priority.