Neoadjuvant chemotherapy may enhance surgical outcomes for locally advanced resectable colon cancer, but careful patient selection is crucial.

• Foxtrot trial showed reduced 2-year residual or recurrent disease (16.9% vs. 21.5%; p=0.037) and higher complete resection rates with fewer complications.
• Optical trial indicated improved overall survival (HR 0.44; p=0.002), though disease-free survival was not statistically significant.

Surgical teams should consider neoadjuvant therapy to improve resection rates and long-term outcomes in select patients.

• Meta-analysis supported better recurrence and survival rates without increased surgical risk.