Key Points
➤ In 2018, approximately 97,000 people living in the United States will be
diagnosed with colon cancer. Of these patients, just less than one-third
will have stage III disease, characterized by spread to regional lymph
nodes and absence of distant metastases.
➤ The primary treatment option for patients with stage III colon cancer is
resection with curative intent, however recurrence rates can be as high as
50–80% with surgery alone.
➤ Adjuvant chemotherapy is recommended to improve overall survival for
patients who have a high risk of recurrence.
Treatment
For patients with stage III resected colon cancer who are being
offered treatment with oxaliplatin-containing chemotherapy:
➤ For patients with high risk (T4 and/or N2) stage III resected colon cancer,
adjuvant oxaliplatin-containing chemotherapy should be offered for a
duration of six months. (Moderate Recommendation; EB-I-B)
➤ For patients with low risk (T1, T2, or T3 and N1) stage III resected colon
cancer, adjuvant oxaliplatin-containing chemotherapy may be offered for a
duration of three months or six months, after a discussion with the patient
of the potential benefits and risks of harm associated with the options for
treatment duration. (Moderate Recommendation; EB-I-B)
➤ A shared decision-making approach should be used for duration of
oxaliplatin-containing chemotherapy for patients with stage III resected
colon cancer, taking into account a patient's tumor characteristics,
completeness of surgical resection, number of lymph nodes examined,
comorbidities, functional status, performance status, values and
preferences, age at diagnosis, life expectancy, potential years at risk
for long-term sequalae of treatment, and including a discussion of the
potential for benefit and risks of harm associated with treatment duration
(Strong Recommendation; CB-B)
