ABSTRACT
Despite the improvements in surgical technique and postoperative care that are outlined in other chapters of this book, colorectal cancer (CRC) continues to kill 95 000 people in Europe alone each year. Approximately one-fifth of the 150 000 annual newly diagnosed cases have metastatic spread at diagnosis, and chemotherapy at this stage can, at best, improve quality of life and prolong life by 6-12 months.1 The remaining 80% of patients have no macroscopic evidence of residual tumour post resection. However, more than half of these subsequently develop recurrence and die of their disease.2 This is a result of viable tumour cells that have metastasized prior to the operation but that are undetectable by our current scanning techniques. Adjuvant chemotherapy administered after a presumed curative operation aims to target these micrometastases and to eradicate them before they can grow into functional tumour masses. Colorectal cancer is just one of a number of solid tumours where this adjuvant stratagem has proven to be effective.
