Adjuvant Therapies In Patients With Colorectal Cancer: An Audit On Clinical Practice In Italy.

3648 Background: Colorectal cancer is a good model for studying adherence to guidelines because of its high incidence and prevalence and availability of clear recommendations. Therefore, we performed a cross-sectional study where the prescriptions of both adjuvant chemotherapy and radiotherapy administered to colorectal cancer patients were audited. Methods: From 2 to 7 October 2000, treatments given to consecutive patients with radically resected colorectal cancer in 82 Italian centers were monitored. Results: Out of 434 patients submitted to adjuvant chemotherapy, 327 (75.4%) were colon cancer, 96 (22.1%) rectal cancer and 11 (2.5%) not specified. Among colon cancer patients, 139 (42.5%) were stage II, 175 (53.5%) stage III and in 13 (4.0%) patients stage was not reported. Treatment at academic centers, young age, T4 and a low total number of lymph nodes removed at surgery were factors explaining the decision to submit stage II colon cancer patients to adjuvant chemotherapy. The most common chemotherapy used was a bolus of 5-fluorouracil / folinic acid for 6 months (77%). Adjuvant radiotherapy was not administered to 37 (38.5%) of 96 patients with stage II and III rectal cancer. Conclusions: A substantial proportion of patients on adjuvant treatment in a large sample of Italian oncological centers are stage II (potential overtreatment) and an undertreatment of stage II and III rectal cancer patients (lack of radiotherapy) occurs too often in daily clinical practice in Italy. No significant financial relationships to disclose.