title: Long-term survival of patients with advanced colorectal cancer may not be due to the response to chemotherapy.
abstract: Our primary objective was to determine the median and overall survival and secondarily the response rate to first- and second-line chemotherapy of patients with advanced colorectal metastatic disease. Three-hundred and seventy-nine patients (median age 60 years, range 30-87 years) were enrolled from April 1993 to March 2000. Median follow-up was 6 years (range 3-10 years), until July 2003. All patients were evaluable for survival and 342 were evaluable for response and toxicity. Thirty-seven patients did not undergo chemotherapy. All patients had confirmed histology as well as metastatic disease based on radiological tests. First-line treatment was administered to 342 patients: leucovorin (LV) 30 mg/m2 and 5-fluorouracil (5-FU) 425 mg/m2. Three different combinations were given as second-line treatment during different chronological periods: i) 5-FU, mitomycin-C and doxorubicin (FAM); ii) 5-FU and cisplatin (CDDP) and iii) 5-FU, LV and irinotecan (CPT-II). Responses were observed as follows: first-line treatment 16.37%, after FAM 25%, following 5-FU-CDDP 26.83% and after 5-FU-LV-CPT-II, 30.61%. Survival of all patients was as follows: median 25 months (range 16.1-33.9 months). The longest survival was of patients on 5-FU-LV-CPT-II. Median survival of patients with stable disease was 19 months and of untreated patients 12 months. Patients with advanced colorectal cancer have a long median (25 months) and overall survival, despite low responsiveness to chemotherapy.
authors.affiliation: Hippokration General Hospital, University Clinic, Oncology Department, Athens, Greece. dr-gps@ath.forthnet.gr
authors.forename: George P
authors.initials: GP
authors.lastname: Stathopoulos
authors.forename: Sotiris K
authors.initials: SK
authors.lastname: Rigatos
authors.forename: Nicos A
authors.initials: NA
authors.lastname: Malamos
authors.forename: John G
authors.initials: JG
authors.lastname: Stathopoulos
authors.forename: Panayiota
authors.initials: P
authors.lastname: Thallasinou
authors.forename: Ekaterini
authors.initials: E
authors.lastname: Papazachariou
authors.forename: Fotini
authors.initials: F
authors.lastname: Antoniou
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Kondopodis
authors.forename: John
authors.initials: J
authors.lastname: Xynotroulas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome