Adjuvant therapy is clearly of great benefit for certain patients with colorectal carcinoma. Validation of new prognostic markers to further define which patients are at highest risk of recurrence will be important. Future investigation for adjuvant therapy includes incorporation of achievements made in the advanced disease setting, including biochemical modulation of 5-FU, identification of new active agents, and incorporation of immunotherapy strategies into adjuvant treatment programs. Further improvements in the treatment of these patients, even if small, may translate into important benefits, given the large number of patients presenting annually with this common cancer. As our therapeutic options broaden and improve, investigators will need to focus on quality of life and pharmacoeconomic parameters to determine which adjuvant approaches are optimal for the individual patient with colorectal cancer, as well as for society in general.