Colon cancer. Clinical practice guidelines in oncology.

Paul F. Engstrom*, A. B. Benson, Leonard Saltz, Comprehensive Cancer Network National Comprehensive Cancer Network

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


The NCCN Colon/Rectal/Anal Cancers Guidelines panel believes that a multidisciplinary approach is necessary for managing colorectal cancer. The panel endorses the concept that treating patients in a clinical trial has priority over standard or accepted therapy. The recommended surgical procedure for resectable colon cancer is an en bloc resection. For patients with stage III disease, 5-FU-based adjuvant therapy is recommended. A patient who has metastatic disease in the liver or lung should be considered for surgical resection if he or she is a candidate for surgery and if surgery can extend survival. Surgery should be followed by adjuvant chemotherapy. The panel advocates a conservative post-treatment surveillance program for colon carcinoma patients. Serial CEA determinations are appropriate if the patient is a candidate for aggressive surgical resection should recurrence be detected. Abdominal and pelvic CT scans should be used only when there are clinical indications of possible recurrence. Patients whose disease progresses during 5-FU-based therapy should be treated with bolus irinotecan. Patients who progress on irinotecan are candidates for 5-FU/leucovorin/oxaliplatin therapy or should be encouraged to participate in a phase I or phase II clinical trial.

Original languageEnglish (US)
Pages (from-to)40-53
Number of pages14
JournalJournal of the National Comprehensive Cancer Network : JNCCN
Issue number1
StatePublished - Jan 2003

ASJC Scopus subject areas

  • Oncology


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