Risk assessment and adjuvant systemic therapy in resected stage II colon cancer

Adjuvant chemotherapy following surgical resection of stage III colon cancer has become the standard of care based on numerous large randomized trials that have demonstrated benefit in overall survival. For patients with stage II colon cancer, the picture is more uncertain. Although clinical trials have not reported a significant survival benefit for adjuvant chemotherapy in stage II disease, patients with certain high-risk clinical and pathologic features may warrant postoperative treatment. Molecular markers, such as 18q loss of heterozygosity and mi crosatellite instability, may also help to prognosticate patients with stage II colon cancer, although data supporting their role have been largely retrospective. The role of these markers in stage II disease is being prospectively investigated. Continued enrollment in clinical trials and further risk stratification will help clarify the optimal management of patients with stage II colon cancer.