© M. Kornmann и др., 2016 ББК: 55.694.133.3 УДК: 616.34-006.6 University of Ulm (Germany) VALUE OF ADJUVANT CHEMOTHERAPY FOR COLON AND RECTAL CANCER FROM A SURGEON’S POINT OF VIEW M. Kornmann, S. Paschke Marko Kornmann Doctor of Medicine, Clinic of General and Visceral Surgery, University of Ulm, Ulm, Germany. <...> Stephan Paschke Doctor of Medicine, Clinic of General and Visceral Surgery, University of Ulm, Ulm, Germany. <...> In order to further improve prognosis the development of distant metastases after primary tumor resection has to be further reduced. <...> Adjuvant chemotherapy with 5-fluorouracil (5-FU) and folinic acid (FA) clearly increases survival in colon cancer UICC stage III. <...> Older patients (≥ 70 years of age) should receive adjuvant treatment as well, because they benefit to the same extent as younger patients. <...> Overall risk reduction by adjuvant treatment is overestimated due to better pre-operative staging (CT) and quality of surgery and pathology resulting in less local recurrence and stage migration. <...> In summary, adjuvant treatment for colon cancer is well established and should include old patients as well. <...> To reduce side effects and increase efficacy adjuvant treatment should be individualized on the basis of UICC substaging and clinical risk factors, maybe also including molecular subtyping. <...> Cure is often achieved in localized cases (UICC stage I and II) with 5-year overall survival rates reaching 90% and more [2]. <...> The prognosis however is already less favourable in locally lymph node positive disease (UICC stage III) with 5-years survival rates about 70% [2]. <...> Advances in many areas of the management of colon and rectal cancer within the last three decades have improved outcome M. Kornmann, S. Paschke 5 years in the presence of distant metastases (UICC stage IV) is still way below 20% among all patients in this subgroup [2]. <...> Systemic adjuvant therapy of colon cancer was established more than 30 years ago demonstrating an effective reduction in recurrence rates in colon cancer compared to resection alone in the landmark study of Moertel and colleagues [4]. <...> Subsequent trials in many countries demonstrated that modulation of 5-FU by addition <...>