Abstract Adjuvant chemotherapy is the current standard in the management of patients with localised colon cancer (CC) following curative resection. The use of oxaliplatin plus 5 fluorouracil/leucovorin (FOLFOX) or oxaliplatin plus capecitabine-based (XELOX) regimens, both approved in Europe as adjuvant treatment for stage III CC, has im- proved prognosis in this stage, but questions on their use- fulness in high-risk stage II or elderly CC patients and on the role of some prognostic biomarkers are still pending. In April 2010, a consensus meeting on adjuvant CC treatment based on a revision of the most recent literature was held in Spain. The panel considered the use of adjuvant chemo- therapy for high-risk stage II CC patients to be justified. Additionally, the more convenient administration of oral fluoropyrimidines vs. IV continuous infusion 5-FU would make XELOX a more suitable alternative for the patient. A more cautious decision should be taken when prescribing oxaliplatin treatment in patients aged 70. Keywords Colorectal neoplasms · Consensus · Spain · Antineoplastic agents · Prognosis · Tumour markers Introduction Colorectal cancer is the third most commonly diagnosed malignancy in men (663,000 cases, 10% of the total) and the second most common in women (570,000 cases, 9.4% of the total) worldwide. Almost 60% of the cases occur in developed regions. In addition, colorectal cancer is the fourth leading cause of cancer deaths, with about 608,000 related deaths each year, which accounts for 8% of all cancer deaths [1]. In 2008, it was one of the most frequent tumours in Europe (436,000 new cases; 13.6% of the total cancers), being the second leading cause of death from cancer (212,000 deaths; 12.3%) [2]. In Spain, there are around 22,000 new cases per year in both sexes, with 13,075 deaths resulting from this disease [3]. Of those, around 70% are localised in the colon and 30% in the rec- tum. In addition, approximately 25% of the patients with colon cancer (CC) have metastatic disease at initial presen- tation and more than 50% subsequently develop metastases and death from this disease. Despite notable therapeutic advances made over the past decade, once the disease has progressed beyond surgical resectability, 5-year survival rates do not generally exceed 10% [4]. Treatment for CC depends on the disease stage. Three characteristics determine the stage of the disease and may point to the prognosis of patients with CC: the degree of penetration of the tumour through the bowel wall (T), the presence or absence of nodal involvement (N) and the pres- ence or absence of distant metastases (M). The stages of this tumour type have been designated by the American Joint Cancer Committee (AJCC) using the TNM (tumour, node, metastases) classification (7th edition) [5] (see Table 1). Most CC patients are first diagnosed at stages II and III. Those with a higher chance of developing recurrent disease (stage III patients) are candidates for adjuvant therapy after complete surgical resection of the primary tumour. In past years, the approval of oxaliplatin, either in combination The affiliations are listed at the end of the article *These authors contributed equally to this work E. Díaz-Rubio () Medical Oncology Department Hospital Clínico Universitario San Carlos C/ Prof. Martín Lagos, s/n ES-28040 Madrid, Spain e-mail: ediazrubio.hcsc@salud.madrid.org Clin Transl Oncol (2011) 13:798-804 DOI 10.1007/s12094-011-0736-4 SPECIAL ARTICLES Recommendations and expert opinion on the adjuvant treatment of colon cancer in Spain José María Vieitez* · Rocío García-Carbonero* · Jorge Aparicio · Jaime Feliu · Encarnación González-Flores · Enrique Grande · Teresa Pérez-Hoyos · Antonieta Salud · Esperanza Torres · María Valero · Manuel Valladares-Ayerbes · Eduardo Díaz-Rubio Received: 17 May 2011 / Accepted: 21 June 2011