Colorectal Cancer: Postoperative Adjuvant Therapy and Surveillance

Recurrence following surgery for colorectal cancer with curative intent is not uncommon. Adjuvant systemic chemotherapy for stage III colon cancer, for stage II/III rectal cancer, and possibly for high-risk stage II colon cancer reduces the risk of recurrence and improves survival. Radiotherapy is more effective and less toxic if given prior to proctectomy rather than postoperatively. Although surveillance testing following curative resection of colorectal cancer has benefit in select patients, the optimal frequency and modality of testing remain unclear. There is a growing consensus regarding the lack of benefit from intensive surveillance regimens. The ability to identify early recurrence provides patients little benefit in terms of cancer-specific survival.