The is now compelling evidence that systemic adjuvant 5-fluorouracil (5-FU) based chemotherapy can delay or reduce recurrence after resection of high-risk (Dukes' C or TNM stage III) colon cancer. A meta-analysis of performed adjuvant studies with intraportal 5-FU suggests that an equal advantage can be obtained with this treatment modality. This might be related to the timing of chemotherapy rather than to the route. In the US large-scale cooperative studies are ongoing or completed that will answer important additional questions such as the more optimal systemic chemotherapy and the duration of treatment. The European Organization for Research and Treatment of Cancer (EORTC) Gastrointestinal Tract Cooperative Group has initiated a large-scale study that compares the combination of 'early' postoperative locoregional directed chemotherapy plus 'late' systemic chemotherapy with systemic chemotherapy only. A plea is made for participation in this European trial that requires 2000 patients.

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