# Localised colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Source: https://onco.cc/key-papers/paper-esmo-localised-colon-cancer-guideline-ann-oncol-2020/  
OnCo record `paper-esmo-localised-colon-cancer-guideline-ann-oncol-2020` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The European guideline for colon cancer that has not spread: who needs chemotherapy after the operation, for how long, and how patients are followed afterwards.

## Summary

ESMO Clinical Practice Guidelines for localised colon cancer, published in Annals of Oncology in 2020 by Argilés, Tabernero, Labianca, Hochhauser, Salazar, Iveson, Laurent-Puig, Quirke, Yoshino, Taieb, Martinelli and Arnold for the ESMO Guidelines Committee. Europe PMC indexes no abstract for this article, so OnCo carries no figures from it.

It is the document that turned the IDEA collaboration's duration result into practice in Europe: three months of CAPOX for lower-risk stage III disease, six months of FOLFOX or CAPOX for T4 or N2 disease, and no adjuvant chemotherapy for mismatch repair-deficient stage II disease.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: colorectal-evidence
- Journal: Annals of Oncology
- Year: 2020
- DOI: 10.1016/j.annonc.2020.06.022
- Authors: Argilés G, Tabernero J, Labianca R, et al.
- Findings: No abstract is indexed on Europe PMC; recommendations are read from the guideline itself.
- What it means: The European rulebook for what happens after a colon cancer operation, and the reason a patient with a T3 N1 tumour is now offered three months of chemotherapy rather than six.
- Caveats: Written before DYNAMIC (2022) showed that a blood test can safely replace clinicopathological risk in stage II, and before ATOMIC (2025) added immunotherapy to adjuvant treatment of mismatch repair-deficient stage III disease.; Guideline text, not a trial.

## Sources

- Ann Oncol 2020: https://doi.org/10.1016/j.annonc.2020.06.022
- PubMed: https://pubmed.ncbi.nlm.nih.gov/32702383/
- ESMO guidelines: gastrointestinal cancers: https://www.esmo.org/guidelines/esmo-clinical-practice-guidelines-gastrointestinal-cancers

## Connected records

- collections: [ESMO Clinical Practice Guidelines & MCBS](https://onco.cc/collections/esmo-guidelines/)
- key papers: [Duration of adjuvant chemotherapy for stage III colon cancer (the IDEA collaboration)](https://onco.cc/key-papers/paper-idea-duration-adjuvant-stage-iii-colon-nejm-2018/)
- cancers: [Colon cancer (adenocarcinoma of the colon)](https://onco.cc/cancers/colon-cancer/), [Colorectal cancer](https://onco.cc/cancers/colorectal/)
- drugs: [Capecitabine](https://onco.cc/drugs/capecitabine/), [CAPOX (capecitabine, oxaliplatin)](https://onco.cc/drugs/capox/), [FOLFOX (5-FU, leucovorin, oxaliplatin)](https://onco.cc/drugs/folfox/)
- institutions: [European Society for Medical Oncology (ESMO)](https://onco.cc/institutions/esmo/)
- terms: [Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)](https://onco.cc/terms/msi/), [Neoadjuvant / adjuvant / perioperative](https://onco.cc/terms/neoadjuvant-adjuvant/)
- people: [Josep Tabernero](https://onco.cc/people/josep-tabernero/)
- journals: [Annals of Oncology](https://onco.cc/journals/annals-of-oncology/)

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