ABSTRACT
Benefit from administration of adjuvant chemotherapy has been firmly demonstrated in Dukes C colon cancer patients based on convincing results from several large prospective randomized trials.1-5 However, the value of such therapy is still argued for patients with Dukes B disease. In 1990, the last US National Institutes of Health (NIH) Consensus Development Conference on colorectal adjuvant therapy recommended that patients with Dukes C colon cancer receive adjuvant chemotherapy with 5-fluorouracil (5-FU) and levamisole (5-FU LEV),6 but did not recommend any specific adjuvant therapy for patients with Dukes B colon cancer outside of clinical trials. The recommendation was mainly based on results from Intergroup study 0035 demonstrating a significant survival improvement with adjuvant 5FU LEV in patients with Dukes C colon cancer but no such improvement in patients with Dukes B disease.1 The lack of survival benefit in Dukes B patients was confirmed in a subsequent update of this trial,7,8
although a reduction in recurrence similar to that documented for Dukes C patients was observed.
