Although neoadjuvant chemotherapy is routinely utilised in the treatment of a variety of solid tumours, it is still understudied in the treatment of locally advanced colon cancer. Early treatment of micro-metastatic disease, the capacity to reduce local disease burden, potentially leading to more effective resections, and enhanced treatment tolerance are all advantages of this technique extrapolated from other disease locations. Large, randomised clinical trials are investigating approaches for accurate staging and safe administration of systemic treatment, but the available data are either not mature enough or have not demonstrated a convincing argument for adoption into standard practise, necessitating further investigation. Although surgical resection is commonly used to treat early stage colon cancer, not all patients achieve a long-term remission. Adjuvant chemotherapy with a fluoropyrimidine, with or without oxaliplatin, is often used to improve cure rates, but its efficacy in the neoadjuvant situation is unknown. Preoperative chemotherapy has been shown to be safe and effective in various gastrointestinal cancers, but there is a scarcity of evidence from big, prospective randomised trials, despite the fact that several are now underway. The theoretical risks and benefits, logistical challenges, and available safety and efficacy evidence relevant to the use of chemotherapy in locally advanced colon cancer will be discussed in this study.
