Duration of Oxaliplatin-Containing Adjuvant Therapy for Stage III Colon Cancer

Based on guidelines from the American Society of Clinical Oncology.

These guideline summaries are shared for educational purposes only and are not intended to direct patient care. For detail on the specific recommendations and information about the evidence considered by the guideline developer, we encourage you to go to the original guideline statement cited below.

Strength

Evidence

Optimal Duration

High Risk of Recurrence (T4 and/or N2)

Moderate recommendation

Intermediate quality evidence

For patients with high-risk (T4 and/or N2) stage III resected colon cancer, adjuvant oxaliplatin-containing chemotherapy should be offered for a duration of 6 months.

Low Risk of Recurrence (T1, T2, or T3 and N1)

Moderate recommendation

Intermediate quality evidence

For patients with low-risk (T1, T2, or T3 and N1) stage III resected colon cancer, adjuvant oxaliplatin-containing chemotherapy may be offered for a duration of 3 months or 6 months after a discussion with the patient of the potential benefits and risks of harm associated with the options for treatment duration.

Approach

Strong recommendation

N/A

A shared decision-making approach should be used for duration of oxaliplatin-containing chemotherapy for patients with stage III resected colon cancer, taking into account a patient’s tumor characteristics, completeness of surgical resection, number of lymph nodes examined, comorbidities, functional status, performance status, values and preferences, age at diagnosis, life expectancy, potential years at risk for long-term sequalae of treatment, and including a discussion of the potential for benefit and risks of harm associated with treatment duration.

Literature

Original/Primary Reference

Lieu C, Kennedy EB, Bergsland E, et al. Duration of Oxaliplatin-Containing Adjuvant Therapy for Stage III Colon Cancer: ASCO Clinical Practice Guideline. J Clin Oncol. 2019;37(16):1436-1447.

What do the ratings mean?

How strong is the ASCO's recommendation?

Strong recommendation

High confidence that recommendation reflects best practice, based on (1) strong evidence for true net effect (benefits > harms); (2) consistent results, with no or minor exceptions; (3) minor or no concerns about study quality; and/or (4) extent of panelists’ agreement.

Moderate recommendation

Moderate confidence that recommendation reflects best practice, based on (1) good evidence for true net effect (benefits > harms); (2) consistent results, with minor and/or few exceptions; (3) minor and/or few concerns about study quality; and/or (4) extent of panelists’ agreement.

Weak recommendation

Some confidence that recommendation offers the best current guidance for practice, based on (1) limited evidence for true net effect (benefits > harms); (2) consistent results, but with important exceptions; (3) concerns about study quality; and/or (4) extent of panelists’ agreement.

High quality evidence

High confidence that available evidence reflects true magnitude and direction of net effect (i.e., balance of benefits vs harms) and that further research is very unlikely to change either magnitude or direction of this net effect.

Intermediate quality evidence

Moderate confidence that available evidence reflects true magnitude and direction of net effect. Further research is unlikely to alter the direction of the net effect; however, it might alter the magnitude of the net effect.

Low quality evidence

Low confidence that available evidence reflects true magnitude and direction of the net effect. Further research may change either the magnitude and/or direction of this net effect.

Insufficient evidence

Evidence is insufficient to discern true magnitude and direction of net effect. Further research may better inform the topic. The use of the consensus opinion of experts is reasonable to inform outcomes related to the topic.

N/A

No evidence was assigned.