Colorectal cancer is the fourth most common noncutaneous malignancy in the United States and the second most frequent cause of cancer‐related death. Approximately three quarters of patients are diagnosed with disease limited to the bowel wall or surrounding lymph nodes. Over the past decade, significant progress has been made in the treatment of localized colorectal cancer due to advances in surgery, radiotherapy, and chemotherapy. For patients with Stage III colon cancer, an overall survival benefit for fluorouracil‐based chemotherapy has been firmly established, and recent data have shown further efficacy through the inclusion of oxaliplatin into adjuvant treatment programs. For patients with Stage II colon cancer, the use of adjuvant chemotherapy remains controversial, but may be appropriate in a subset of individuals at high risk for disease recurrence. In the treatment of patients with rectal cancer, improved outcomes have been noted with the use of total mesorectal excision and preoperative concurrent chemoradiotherapy. Current randomized clinical trials in the adjuvant therapy of colorectal cancer are examining the value of adding agents known to be active in metastatic disease, including those that modify specific molecular targets.

中文翻译：

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结直肠癌的辅助治疗

结直肠癌是美国第四大常见的非皮肤恶性肿瘤，也是癌症相关死亡的第二大常见原因。大约四分之三的患者被诊断为仅限于肠壁或周围淋巴结的疾病。在过去的十年中，由于手术、放疗和化疗的进步，局部结直肠癌的治疗取得了重大进展。对于 III 期结肠癌患者，以氟尿嘧啶为基础的化疗的总体生存获益已经确定，最近的数据表明，通过将奥沙利铂纳入辅助治疗计划可进一步提高疗效。对于 II 期结肠癌患者，辅助化疗的使用仍存在争议，但可能适用于疾病复发高风险的一部分个体。在直肠癌患者的治疗中，已经注意到使用全直肠系膜切除术和术前同步放化疗可改善结果。目前结直肠癌辅助治疗的随机临床试验正在研究添加已知对转移性疾病有活性的药物的价值，包括那些改变特定分子靶点的药物。