Multiple localized metachronous recurrences in a patient of colon cancer and therapeutic controversies in stage II colon cancer

Recurrences of colon cancer occurs in 30–40% of the patients after successful initial therapy and most commonly occur at distant sites like liver, lungs and lymph nodes. Here we present a patient who presented with localized metachronous recurrences of colonic cancer over a span of 20 years; each time presenting in stage II and was successfully salvaged with surgery followed by adjuvant chemotherapy. Recurrences were detected on screening colonoscopy at each instance. We also discuss the role of adjuvant chemotherapy in stage II colon cancer, current indications of chemotherapy and the role of gene assays. The independent survival benefit conferred by screening treated patients with colon cancer is also highlighted.