Standard surgical treatment for localized colon cancer is radical resection of primary and regional lymph nodes. Stage Ⅰ patients do not need any adjuvant therapy after resection. While

adjuvant chemotherapy has proven benefit in stage Ⅲ colon cancer. At present

its potential value for stage Ⅱ colon cancer remains controversial. Currently

6 months of adjuvant chemotherapy following primary surgical treatment has been recommended as standard care for stage Ⅲ patients. Some evidence does not support a widespread use of adjuvant therapy in stage Ⅱ colon cancer. However

in our views of points

some high-risk stage Ⅱ patients

defined as those with poor prognostic features including T4 tumors

poor histological grade (grade 3 or 4 lesions)

lymphovascular invasion

perineural invasion

bowel obstruction

lesions with localized perforation or close

indeterminate

or positive margins

and inadequately sampled nodes (less than 12 lymph nodes)

should be considered for adjuvant chemotherapy. Irinotecan and target agents such as bevacizumab

cetuximab

or panitumumab must be avoided in the adjuvant setting. Perioperative regional liver chemotherapy has not been proven to reduce the rate of liver metastases or improve overall survival for resected colon cancer patients.