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Stage III Colon Cancer Treatment

    Stage III colon cancer denotes lymph node involvement. Studies have indicated that the number of lymph nodes involved affects prognosis; patients with one to three involved nodes have a significantly better survival than those with four or more involved nodes.

    Standard Treatment Options for Stage III Colon Cancer

    Recommended Related to Colorectal Cancer

    Who is at Risk?

    For the great majority of people, the major factor that increases a person's risk for colorectal cancer (CRC) is increasing age. Risk increases dramatically after age 50 years; 90% of all CRCs are diagnosed after this age. The history of CRC in a first-degree relative, especially if before the age of 55 years, roughly doubles the risk. Other risk factors are weaker than age and family history. People with inflammatory bowel disease have a much higher risk of CRC. A small percentage (<5%) of CRCs...

    Read the Who is at Risk? article > >

    Standard treatment options for stage III colon cancer include the following:

    1. Surgery.
    2. Adjuvant chemotherapy.

    Surgery

    Surgery for stage III colon cancer is wide surgical resection and anastomosis.

    Evidence (laparoscopic techniques):

    The role of laparoscopic techniques [1,2,3,4] in the treatment of colon cancer was examined in a multicenter, prospective, randomized trial (NCCTG-934653, now closed) comparing laparoscopic-assisted colectomy (LAC) with open colectomy.

    • Three-year recurrence rates and 3-year overall survival (OS) rates were similar in the two groups. (Refer to the Primary Surgical Therapy section in the Treatment Option Overview section of this summary for more information.)
    • The quality-of-life component of this trial has been published and minimal short-term quality-of-life benefits with LAC were reported.[5][Level of evidence: 1iiC]

    Adjuvant chemotherapy

    Drug combinations described in this section include the following:

    • The FOLFOX4 regimen (oxaliplatin, leucovorin, and fluorouracil [5-FU]):
      • Oxaliplatin (85 mg/m2) administered as a 2-hour infusion on day 1; leucovorin (200 mg/m2) administered as a 2-hour infusion on day 1 and day 2; followed by a loading dose of 5-FU (400 mg/m2) intravenous bolus, then 5-FU (600 mg/m2) administered via ambulatory pump for a period of 22 hours on day 1 and day 2 every 2 weeks.
    • The Levamisole regimen (5-FU and levamisole):
      • Bolus 5-FU (450 mg/m2 per day) on days 1 to 5, then weekly 28 days later plus levamisole (50 mg) administered orally 3 times a day for 3 days every 2 weeks.
    • The Mayo Clinic or North Central Cancer Treatment Group (NCCTG) regimen (5-FU and low-dose leucovorin):
      • Bolus 5-FU (450 mg/m2)-leucovorin (20 mg/m2) administered daily for 5 days every 28 days.
    • The Roswell Park or National Surgical Adjuvant Breast and Bowel Project (NSABP) regimen (5-FU and high-dose leucovorin):
      • Bolus 5-FU (500 mg/m2)-leucovorin (500 mg/m2) administered weekly for 6 consecutive weeks every 8 weeks.
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