Progress in the Adjuvant Treatment of Colon Cancer Has It Influenced Clinical Practice?

摘要

Among patients with colon cancer, 70% present with apparently localized disease. In these patients, surgery can be curative, but relapses after complete resection are frequent. Colon cancer is not uniformly fatal and there are large differences in survival depending on the stage of the disease at diagnosis. The pathological stage is currently the most important determinant of prognosis. The classification system described by Dukes in 1930 is still widely used, but it no longer fulfills the requirements of modern tumor staging because it does not take into account distant metastases, number of lymph nodes involved, and carcinomas limited to the submucosa. Therefore, the TNM classification of the American Joint Committee on Cancer (AJCC) is recommended both for daily clinical practice and for clinical trials. The AJCC Cancer Staging Manual is now used to stage colon cancer and all other cancers, and the latest edition stratifies colon cancer stages II and III further by use of T stage (ie, tumor depth ofpenetration) and N stage.