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Revisiones en Cáncer 00137 / http://dx.doi.org/10.20960/revcancer.00137

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Adyuvancia en cáncer de colon en estadios II-III: 3 frente a 6 meses, MSI-H, integración de ctDNA

Carles Pericay Pijaume, Marta Monteis Pla, Esther Falcó Ferrer, Julen Fernández Plana

Prepublicado: 2026-01-26

Logo Descargas Número de descargas: 54 Logo Visitas Número de visitas: 6 Citas Citas: 0

Compártelo:

El tratamiento adyuvante en el cáncer de colon en estadio II (EII) debe reservarse para situaciones con factores de mal pronóstico (pT4, < 12 ganglios, perforación). El tratamiento en el estadio III (EIII) es una combinación de oxaliplatino (FOLFOX/CAPOX). El estudio IDEA aporta evidencia para disminuir el tratamiento de 6 a 3 meses en tumores de menor riesgo (T1-T3, N1). Esta reducción del tratamiento disminuye significativamente la toxicidad residual y mejora la calidad de vida, sin impactar en la supervivencia libre de recidiva (SLR). Los tumores MSI-H(EII), presentan mejor pronóstico y el tratamiento con fluoropirimidinas empeora la SLR. Los MSI-H(EIII) deben tratarse con combinaciones de oxaliplatino; no queda claro el efecto de reducir el tratamiento de 6 a 3 meses. La determinación de ctDNA poscirugía ha demostrado ser útil para conocer el pronóstico, pero los estudios no han podido validar, hasta la fecha, su utilización para modular el tratamiento adyuvante a aplicar a los pacientes.

Palabras Clave: Adenocarcinoma de colon. Adyuvancia. Tratamiento. MSI-H. ctDNA.

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