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Colorectal Cancer — SCE Medical Oncology MCQ

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ModerateGI CancersColorectal CancerSCE Medical Oncology

A 60-year-old man with colorectal cancer liver metastases undergoes neoadjuvant FOLFOX followed by right hepatectomy. Pathology shows a complete pathological response (no viable tumour). Should he receive adjuvant chemotherapy?

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Correct answer: A — Yes — complete perioperative chemotherapy (total 6 months, including neoadjuvant portion)

The EPOC trial established 6 months of total perioperative FOLFOX (3 months pre-surgery + 3 months post-surgery) for resectable colorectal liver metastases. Even with complete pathological response, adjuvant chemotherapy completion is recommended to treat potential micrometastatic disease elsewhere. The total perioperative chemotherapy duration should not exceed 6 months to avoid excess hepatotoxicity.

Reference: ESMO 2024 Metastatic Colorectal Cancer Guidelines; EPOC Nordlinger et al Lancet 2008; NICE NG151