Indication and efficacy of adjuvant chemotherapy with oral fluoropyrimidines for dukes' B colorectal cancer.
BACKGROUND
Identifing patients prone to colorectal cancer recurrence is of importance in providing appropriate adjuvant chemotherapy. In this retrospective study on Dukes' B colorectal cancer, patients at high risk of recurrence were identified by clinicopathological factors, and the efficacy of adjuvant chemotherapy with oral fluoropyrimidines was evaluated.


METHODS
The subjects were 229 patients with Dukes' B colorectal cancer who had undergone curative surgical resection. The relationship between each factor and cancer-related survival was examined.


RESULTS
In all the patients, the 5-year cumulative survival rate was 83.5% and the recurrence rate was 20.1%. The multivariate analyses indicated that the depth of invasion was the most significant prognostic factor. The cases with tumor exposed at the serosa or which invaded other organs were considered as a high-risk group. The 5-year survival rate in high-risk patients with adjuvant chemotherapy was significantly better than those without chemotherapy (75.8% and 44.0%, respectively, p=0.0008). The patients who received chemotherapy tended to show a decrease in the recurrence rate, especially in the liver and lung (p=0.0346).


CONCLUSIONS
In Dukes' B colorectal cancer, the cases with invasion depth se or si were considered to be at high risk of recurrence or death. Adjuvant chemotherapy was effective for such high-risk patients, especially decreasing recurrence in the liver and lung.
Yoshimatsu
Kazuhiko
K
Department of Surgery, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu Arakawaku Tokyo, 116-8567, Japan.
Umehara
Arihiro
A
Ishibashi
Keiichiro
K
Yokomizo
Hajime
H
Yoshida
Kiyohito
K
Fujimoto
Takashi
T
Watanabe
Kiyo
K
Ogawa
Kenji
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use*; D012189:Retrospective Studies; D005641:Tegafur / Q000008:administration & dosage; D014498:Uracil / Q000008:administration & dosage
D011743:Pyrimidines; D005641:Tegafur; D014498:Uracil