After curative surgery, a subgroup of patients with early stage colon cancer (CC) has an increased risk of recurrence. Adjuvant chemotherapy can decrease this cancer recurrence risk but this treatment has serious side effects and leads to additional health care costs. To maximize survival benefit on the one hand and to minimize the number of futile treatments on the other hand, careful selection of patients who may benefit of adjuvant therapy is essential. Unfortunately, current selection procedures lack a well-founded evidence-base. Furthermore, new developments in the field of genetics enable selection based on the molecular nature of the tumour. Recently, ZonMw has awarded a grant (grantnr 848015007) to a research proposal of Veerle Coupé that aims to identify the optimal selection procedure. The results of such a study can be used to inform clinical guidelines.
This study aims to compare new, molecular methods to select patients with early CC after curative surgery who may benefit from adjuvant chemotherapy to the current selection procedure. Several selection methods will be compared in terms of long-term health benefits as well as cost-effectiveness. For these analyses, a decision model based on all available evidence will be developed.