**Conflict of interest**

The authors declare no conflicts of interests.

*Adjuvant Therapies in Colon Cancer DOI: http://dx.doi.org/10.5772/intechopen.93874*

*Colorectal Cancer*

**10. Conclusion**

**Conflict of interest**

overall survival benefit from intensive surveillance. Intensive follow up resulted in higher rates of salvage surgeries with curative intent; however, this did not result in improved survival. Furthermore, these results were confounded by heterogeneity of the trials included in the meta-analyses. For example, definition of intensive versus less intensive follow up varied among the trials in terms of frequency of follow up [78]. In addition some trials included patents with stage I disease who have low rates of recurrence. Despite inconsistencies in the data, and the fact that curative metastasectomy improves survival in colorectal cancer patients, intensity of follow up should be tailored according to patient and cancer characteristics. Surveillance modalities include physical examination, carcino-embryonic antigen (CEA) and computerized tomography (CT) for surveillance. Follow up guidelines varies between the expert groups [79, 80]. A relatively intense follow up is reasonable for the first 3 years after the curative surgery, with 3–6 monthly physical examination and measurement of CEA. A 12 monthly CT scan is appropriate for the first 3 years and CT scans should be performed on any clinical suspicion thereafter. A colonoscopy is indicated after adjuvant therapy, if a complete colonoscopy was not performed at the time of surgery. Otherwise a routine colonoscopy should be performed at 12 months and then 5-yearly unless an adenomatous polyp is found

Colon cancer is one of the leading cause or morbidity and mortality in the world with incidence increasing, especially in younger population. Advances in systemic chemotherapeutic options have improved the survival. Adjuvant chemotherapy has been shown to reduce the risk of recurrence after resection of primary colon cancer; however, it is associated with chemotherapy related morbidity and mortality. Clinicopathological features and molecular characteristics of the tumor need to be carefully assessed and adjuvant therapy should be tailored accordingly in order to avoid futile treatment and serious toxicities. Advances in genomic profiling and evolution of detection of circulating tumor DNA are promising and may guide the

which should prompt an earlier follow up colonoscopy.

choice and intensity of treatment in the future.

The authors declare no conflicts of interests.

**174**
