FOLFOX as adjuvant chemotherapy after curative resection of distant metastases in patients with colorectal cancer.

Abstract

OBJECTIVES:

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: Hiroaki Nozawa, Joji Kitayama, Eiji Sunami, Shinsuke Saito, Takamitsu Kanazawa, Shinsuke Kazama, Kentaro Yazawa, Kazushige Kawai, Ken Mori, Hirokazu Nagawa
• Journal: Oncology (Oncology) Vol. 80 Issue 1-2 Pg. 84-91 ( 2011) ISSN: 1423-0232 [Electronic] Switzerland
• PMID: 21677451 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 S. Karger AG, Basel.

Chemical References

• Organoplatinum Compounds
• Leucovorin
• Fluorouracil

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects, therapeutic use)
• Chemotherapy, Adjuvant
• Colorectal Neoplasms (drug therapy, pathology, surgery)
• Disease-Free Survival
• Female
• Fluorouracil (administration & dosage, adverse effects)
• Humans
• Kaplan-Meier Estimate
• Leucovorin (administration & dosage, adverse effects)
• Logistic Models
• Lymphatic Metastasis
• Male
• Middle Aged
• Neoplasm Metastasis
• Neoplasm Recurrence, Local
• Organoplatinum Compounds (administration & dosage, adverse effects)
• Retrospective Studies
• Survival Rate