van den Berg I, van de Weerd S, van Klaveren D, et al. - Many patients with stage III colon cancer do not receive adjuvant chemotherapy, even though it is recommended by guidelines for these patients. In a multicenter cohort of stage III colon cancer patients who received surgery plus adjuvant chemotherapy or surgery alone, researchers sought to determine the reasons for not adhering to the guidelines and examined its impacts on patient outcomes. They assessed data of 575 patients; of these, 61% were reported to have received adjuvant chemotherapy. Overall, guideline adherence to adjuvant chemotherapy varied considerably and there was poor documentation on reasons for non-adherence. No reason was documented for not receiving adjuvant chemotherapy in 87 of 222 patients (39%). Only age was identified to be predictive for receiving chemotherapy. Based on findings, they emphasize optimization of adherence and attaining insight in reasons for non-adherence as this can result in significant benefit in recurrence free survival (RFS), especially in patients with high T-and N-stage tumors.