National Comprehensive Cancer Network

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New NCCN Treatment Recommendations for Colon and Rectal Cancers

ROCKLEDGE, PA, February 4, 2003 - The National Comprehensive Cancer Network (NCCN) announces the publication of the first of the 2003 NCCN Clinical Practice Guidelines in Oncology, the Colon and Rectal Cancer Treatment Guidelines, in the January edition of JNCCN, the official journal of the NCCN. These updated guidelines contain new treatment recommendations regarding the use of the recently approved agent, oxaliplatin, and of radiation therapy in Stage II, III, and IV disease.

“The inclusion of the new agent, oxaliplatin, in the guidelines almost immediately following its FDA approval demonstrates the capacity for these guidelines to provide the most current information about the state-of-the-art to practicing oncologists,” said Rodger J. Winn, MD, Chair of the NCCN Guidelines Steering Committee. “Additional therapies, such as oxaliplatin, for this difficult-to-treat disease may have a favorable impact on quality of life and potentially extend survival. Therefore, each new therapy is an important step in managing this disease.”

These recommendations are as follows:

Rectal Cancer:

  • for patients with distant, unresectable, or multiple metastatic lesions, combination chemotherapy with 5-FU/leucovorin/oxaliplatin is now included as one of several treatment options found to be effective as palliative therapy.
  • for Stage IV patients with distant resectable metastases, radiation therapy to the pelvic area should now be considered as a therapeutic option as adjuvant therapy after combination chemotherapy and resection of the metastases and the rectal lesion.

Colon Cancer:

  • for patients with unresectable or multiple metastatic lesions, 5-FU/leucovorin/oxaliplatin is now included as one of several treatment options found to be effective as palliative therapy.
  • for Stage II and III patients, combination regimens including irinotecan, oxaliplatin, and capecitabine cannot be considered as standard adjuvant therapy at this time but may be administered in the context of a clinical trial.
  • for Stage II or Stage III patients with localized perforation or with close, indeterminate, or positive margins, radiation therapy is recommended as part of a therapeutic adjuvant regimen.
  • for Stage IV patients with resectable liver metastases, 5-FU/leucovorin/oxaliplatin is now included as one of several treatment options that is effective as neoadjuvant or adjuvant therapy.

NCCN Clinical Practice Guidelines in Oncology are widely recognized and used as the standard for clinical policy in cancer care. The NCCN Complete Library of Clinical Practice Guidelines in Oncology is the only comprehensive set of guidelines updated annually by any national organization in any area of medicine.

These guidelines represent the integration of best available scientific evidence and expert opinion in a consensus approach involving thought leaders from medical, surgical, and radiation oncology and other pertinent clinical areas. The NCCN guidelines are distributed free of charge to clinical professionals in the United States and internationally. An updated 2002/2003 version of the NCCN Clinical Practice Guidelines in Oncology will be available in CD-ROM format and online at by March 15. User-friendly patient versions of NCCN guidelines are available to patients and their families at the same Web address.

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 27 leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The primary goal of all NCCN initiatives is to improve the quality, effectiveness, and efficiency of oncology practice so patients can live better lives. For more information, visit

The NCCN Member Institutions are:

  • Fred & Pamela Buffett Cancer Center
  • Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
  • City of Hope Comprehensive Cancer Center
  • Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center
  • Duke Cancer Institute
  • Fox Chase Cancer Center
  • Huntsman Cancer Institute at the University of Utah
  • Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
  • The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
  • Robert H. Lurie Comprehensive Cancer Center of Northwestern University
  • Mayo Clinic Cancer Center
  • Memorial Sloan Kettering Cancer Center
  • Moffitt Cancer Center
  • The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
  • Roswell Park Cancer Institute
  • Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
  • St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
  • Stanford Cancer Institute
  • University of Alabama at Birmingham Comprehensive Cancer Center
  • UC San Diego Moores Cancer Center
  • UCSF Helen Diller Family Comprehensive Cancer Center
  • University of Colorado Cancer Center
  • University of Michigan Comprehensive Cancer Center
  • The University of Texas MD Anderson Cancer Center
  • University of Wisconsin Carbone Cancer Center
  • Vanderbilt-Ingram Cancer Center
  • Yale Cancer Center/Smilow Cancer Hospital