Adjuvant therapies for colorectal cancer

Table 1 TNM staging system for colon cancer with AJCC stage grouping[57]

AJCC stage	TNM category
Stage 0	Tis, N0, M0
StageI	T1, N0, M0
	T2, N0, M0
Stage IIA	T3, N0, M0
Stage IIB	T4, N0, M0
Stage IIIA	T1-T2, N1, M0
Stage IIIB	T3-T4, N1, M0
Stage IIIC	Any T, N2, M0
Stage IV	Any T, Any N, M1

Table 2 TNM staging system for colon cancer[57]

	Tumour stage (T)	Nodal stage (N)	Metastasis (M)
X	Primary tumour can not be assessed	Nodal metastasis can not be assessed	Distant metastasis can not be assessed
0	No primary tumor identified	No nodal metastasis	No distant metastases
is	Carcinoma in situ (tumour limited to mucosa
1	Involvement of submucosa, but no penetration through muscularis propria	1-3 pericolic/ perirectal nodes involved.	Distant metastases
2	Invasion into, but not penetration through, muscularis propria	4 or more pericolic/ perirectal nodes involved
3	Penetration through muscularis propria in o subserosa (if present), or pericolic fat, but not into peritoneal cavity or other organs.
4	Invasion of other organs or involvement of free peritoneal cavity

Table 3 Common adjuvant chemotherapy regimens for colon cancer

Chemotherapy Regimen	Drugs	Route	Dosage	Cycle length and number
Mayo Regimen[58]	5-FU/LV	iv	5-FU, 425 mg/m2 per day d 1-5	28 d
			LV 20 mg/m2 per day d 1-5	6 cycles
Roswell Park [59]	5-FU/LV	iv	5-FU 500 mg/m2 per day weekly × 6	8 wk
			LV 500 mg/m2 per day weekly × 6	4 cycles
Xeloda [24]	Capecitabine	oral	1250 mg/m2	21d
			BD × 14 d	8 cycles
FOLFOX 4 [31]	5-FU/LV	iv	Oxaliplatin 85 mg/m2 d 1	14 d
	Oxaliplatin		LV 200 mg/m2 per d d 1-2	12 cycles
			5-FU 400 mg/m2 per day d 1-2
			5-FU, 600 mg/m2 per d CVI over 22 h, d 1-2
FLOX [32]	5-FU/LV	iv	Oxaliplatin 85 mg/m2 wk 1, 3, 5	8 wk
	Oxaliplatin		LV 500 mg/m2 wk 1-6	3 cycles
			5-FU 500 mg/m2 wk 1-6

CVI: Continuous venous infusion; LV: Leucovorin calcium; iv: intravenous.

Table 4 Rates of local recurrence according to stage at diagnosis, surgical management and the inclusion of radiotherapy for rectal cancer (%)

Stage atdiagnosis	Surgeryalone[41]	Total mesorectalexcision[42]	TME plusradiotherapy[42]
StageI	14	0.7	0.5
Stage II	22	5.7	1.0
Stage III	46	15	4.3

TME: Total mesorectal excision.

Table 5 2005 ASCO Guidelines for post-treatment surveillance[6]

Year postdiagnosis	History andphysical review	CEA level	CT scan chestand abdomen	Colonoscopy
Yr 1	3-6 monthly	3 monthly	Yearly
Yr 2	3-6monthly	3 monthly	Yearly
Yr 3	3-6 monthly	3 monthly	Yearly	Colonoscopy
Yr 4	6 monthly	At review	Nil
Yr 5	6 monthly	At review	Nil

CEA: Carcinoembryonic antigen.