6
Treatment
Table 5. High-Risk Obstructing Colon Cancer and Colon
Cancer Diagnoses Eligible for Adjuvant Treatment
Population Intervention Setting
Patients with
obstructing, locally
advanced (ie., with
invasion of adjacent
structures) colon
cancer T4N0/
T3N0 high-risk
features (high risk-
obstructing )
Medical oncologists should offer adjuvant
chemotherapy aer surgery and fully discussing
the risks and benefits with the patient. (Strong
Recommendation; H)
Enhanced
and
Maximal
Patients with high-
risk, obstructing stage
II colon cancer
Medical oncologists may offer adjuvant
chemotherapy aer surgery and fully discussing
the risks and benefits with the patient. (Strong
Recommendation; H)
Enhanced
and
Maximal
Patients with high
risk, obstructing stage
III colon cancer
Medical oncologists should offer adjuvant
chemotherapy aer surgery and fully discussing
the risks and benefits with the patient. (Strong
Recommendation; H)
Maximal
Table 6. Rectal Cancer Stage I– clinical stage T1 N0
Population Intervention Setting
Patients with
nonmetastatic cT1N0
rectal cancer
General surgeons should perform surgery
following total mesorectal excision (TME)
principles. (Strong Recommendation; H)
Basic and
Limited
Patients with
nonmetastatic cT1N0
rectal cancer
Surgical oncologists/and or colorectal surgeons
should perform TME following standard
oncologic principles and, in Maximal settings,
using the most advanced techniques. (Strong
Recommendation; H)
Enhanced
and
Maximal
Patients with select
low risk (cT1N0
without adverse
features like G3, V1,
L1) T1N0 rectal
cancers
Surgical oncologists and/or colorectal surgeons
may perform local excisional procedures such as
TEM. (Moderate Recommendation; I)
Maximal
