Clinical impact of adjuvant chemotherapy on patients with stage III colorectal cancer: l-LV/5FU chemotherapy as a modified RPMI regimen is an independent prognostic factor for survival.
BACKGROUND
Patients with stage III colorectal cancer have a substantial risk of microscopic metastatic disease at the time of resection. Treatment with leucovorin (LV)/5-Fluorouracil (5FU) has been demonstrated to be effective for advanced colorectal cancer; however, the clinical impact of l-LV/5FU is still unclear. 1-LV/5FU for patients with stage III colorectal cancer may play an important role, as an adjuvant chemotherapy, in improving survival.


METHODS
The clinicopathological features of 36 patients receiving adjuvant l-LV/54 administration and 16 not, univariate analysis of potential predictors of overall survival and disease-free survival, relative risk of overall survival and disease-free survival by multivariate analysis and the occurrence of chemotherapy-induced toxic effects were studied in 52 patients with stage III colorectal cancer, including 30 with rectal and 22 with colon cancer, who had undergone surgery.


RESULTS
No significant differences were found in the clinicopathological features of the 2 groups. On univariate analysis, there were no significant differences in overall survival in either group; disease-free survival in patients with adjuvant I-LV/5FU was longer than that in patients without it (p<0.001). Moreover, multivariate analysis demonstrated that I-LV/5FU adjuvant chemotherapy was an independent prognostic factor in terms of disease-free survival (p =0.001; RR, 17.492; 95% CI, 3.298-92.778).


CONCLUSIONS
I-LV/5FU adjuvant chemotherapy in patients with stage III colorectal cancer is important as an independent prognostic factor in terms of disease-free survival.
Hotta
Tsukasa
T
Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
Takifuji
Katsunari
K
Arii
Kazuo
K
Yokoyama
Shozo
S
Matsuda
Kenji
K
Higashiguchi
Takashi
T
Tominaga
Toshiji
T
Oku
Yoshimasa
Y
Yamaue
Hiroki
H
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging
D002955:Leucovorin; D005472:Fluorouracil