title: FOLFOX as adjuvant chemotherapy after curative resection of distant metastases in patients with colorectal cancer.
abstract: OBJECTIVE
  The prophylactic effect of FOLFOX regimen, a standard regimen for unresectable colorectal cancer (CRC), was investigated in the adjuvant setting of CRC cases with distant metastases.
  
  
  METHODS
  The study population included 116 CRC patients with synchronous metastases and 91 patients with metachronous metastases who had undergone curative operation in our hospital between 2000 and 2009. Clinicopathological parameters of CRC, postoperative chemotherapeutic regimen, recurrence rate, and relapse-free survival (RFS) were analyzed retrospectively.
  
  
  RESULTS
  After resection of CRC and synchronous metastases, 53 (84%) out of 63 patients without chemotherapy, and 38 (83%) out of 46 that received 5-fluorouracil (5-FU) alone or with leucovorin (LV) developed recurrent tumors. By contrast, only 1 (17%) among 6 patients who underwent FOLFOX treatment showed recurrence. The FOLFOX group exhibited significantly improved RFS as compared to the 5-FU (+ LV) or surgery-alone group (p = 0.03, p = 0.007, respectively). On the other hand, in patients with metachronous metastases, tumor-relapse rate and RFS were not significantly influenced by post-metastasectomy therapies.
  
  
  CONCLUSIONS
  In this retrospective analysis, the adjuvant administration of FOLFOX appeared to reduce the risk of relapse in a small group of CRC patients with synchronous metastases. Prospective randomized trials will be required to confirm the benefits of this management strategy.
authors.affiliation: Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan. hiroanozawa-gi@umin.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nozawa
authors.forename: Joji
authors.initials: J
authors.lastname: Kitayama
authors.forename: Eiji
authors.initials: E
authors.lastname: Sunami
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Saito
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Kanazawa
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kazama
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yazawa
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kawai
authors.forename: Ken
authors.initials: K
authors.lastname: Mori
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nagawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / 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; D053208:Kaplan-Meier Estimate; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil