IMPACT OF NEO-ADJUVANT CHEMOTHERAPY IN COLON CANCER

Surgery with adjuvant chemotherapy is currently the gold standard in the management of locally advanced non-metastatic colon cancer. However a peri-operative strategy is beginning to emerge. The aim of this randomized trial is to report a series of 110 patients operated on for locally advanced non-metastatic colon cancer with evaluation of the impact of neo-adjuvant chemotherapy versus primary surgery in terms of overall survival and recurrence-free survival with the quality of the complete surgery and histological tumor regression as well as postoperative morbidity and mortality as endpoints. The results show a benefit of neoadjuvant chemotherapy on the quality of surgical excision by down sizing as well as a reduction of major postoperative morbidity and on the anatomopathological results by down staging and partial histological response. There seems to be a superiority of neoadjuvant chemotherapy in terms of median overall survival and recurrence-free survival. This new peri-operative strategy seems to provide tumor control. It would be a kind of pre-enabling for surgery.