Recurrence and 5-FU sensitivity of stage III/Dukes' C colorectal cancer with occult neoplastic cells in lymph node sinuses.

Abstract

In 72 patients without occult neoplastic cells (ONCs) in their lymph node sinuses, the 5-year relapse-free survival (RFS) rate and overall survival (OS) rate were 71.3% and 69.2%, respectively. In 33 patients with ONCs, the 5-year RFS rate and OS rate were 33.9% and 31.3%, respectively. There was a marked difference of survival between the two groups (p=0.0001 and p=0.0003). The metastatic lymph nodes of the 33 ONC-positive patients had high and low levels of thymidilate synthase (TS) expression in 38.1% (8/21) and 61.9% (13/21) of the recurrence group (n=21), respectively, while high and low levels of dihydropyrimidine dehydrogenase (DPD) expression were found in 38.1% (8/21) and 61.9% (13/21), respectively. In the non-recurrence group (n=12), high and low levels of TS or DPD expression were detected in 58.3% (7/12) and 41.7% (5/12) versus 16.7% (2/12) and 83.3% (10/12), respectively. Patients with high TS and low DPD expression accounted for 9.5% (2/21) of the recurrence group and 50.0% (6/12) of the non-recurrence group (p<0.01). These results suggest that ONCs are clearly associated with the 5-year RFS and OS rates. Unlike the non-recurrence group, the recurrence group of ONC-positive patients with Dukes' C colorectal cancer is unlikely to respond well to treatment with 5-FU plus LV and require combination chemotherapy based on CPT-11 and/or L-OHP.

• Authors: Masaya Mukai, Shinkichi Sato, Hiromi Ninomiya, Kanako Wakui, Nobukazu Komatsu, Kazutoshi Tsuchiya, Hisao Nakasaki, Hiroyasu Makuuchi
• Journal: Oncology reports (Oncol Rep) Vol. 14 Issue 5 Pg. 1165-9 (Nov 2005) ISSN: 1021-335X [Print] Greece
• PMID: 16211280 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• Dihydrouracil Dehydrogenase (NADP)
• Thymidylate Synthase
• Leucovorin
• Fluorouracil

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biomarkers, Tumor (blood)
• Colorectal Neoplasms (drug therapy, pathology)
• Dihydrouracil Dehydrogenase (NADP) (biosynthesis, blood)
• Disease-Free Survival
• Fluorouracil (administration & dosage)
• Follow-Up Studies
• Humans
• Immunohistochemistry
• Leucovorin (administration & dosage)
• Lymphatic Metastasis
• Neoplasm Staging
• Thymidylate Synthase (biosynthesis, blood)