Staging, prognosis, and survivorship in colon cancer

The American Joint Committee on Cancer released the seventh edition of their staging manual for colon cancer in 2010. The biggest changes were the subcategories added for stages II and III colon cancer, as there is a significant difference in survival based upon the tumor depth of invasion (T stage) within these two stages. The eighth edition is awaiting release in the near future. However, there continues to be a dilemma of which patients with stage II cancer may benefit from adjuvant chemotherapy. There are guidelines that now include clinical, pathologic, and genomic factors that allow us to stratify patients into high-risk and low-risk categories, and we should evaluate the different factors and how they are used clinically. Survivorship of colon cancer is becoming a new focus of care, as more patients than ever are living after treatment for colon cancer. There are important psychosocial and clinical aspects of their care that must be addressed to ensure an adequate quality of life and disease-free survival long after their cancer treatment regardless of “cure.”