BACKGROUND AND AIMS: The liver represents the predominant site of cancer relapse after curative resection of hepatic metastases from colorectal carcinoma. Adjuvant intra-arterial chemotherapy was therefore considered a promising therapeutic approach in high-risk patients. PATIENTS/ METHODS:From July 1984 to December 1985, a total of 42 consecutive patients underwent R0 resection of colorectal liver metastases. Thirty patients with mesenteric lymph-node metastases (Dukes C) were randomised into two groups. In 14 group-A patients, a hepatic artery port catheter was placed during liver resection. Four courses of adjuvant chemotherapy were administered at 4-week intervals, consisting of mitomycin C (8 mg/m2, day 1) and 5-fluorouracil (800 mg/m2, days 1-5). Sixteen group-B patients served as controls. The 12 patients with no mesenteric lymph-node metastases (Dukes A/B) were included in the follow-up program. RESULTS: After 5 years, 64% of Dukes A/B patients and 29% of Dukes C patients were alive (P<0.01). The probability of remaining free of recurrent disease after 5 years and 10 years was 55% and 18%, respectively (P<0.01). No significant difference in either 5-year survival (25% vs 31%) or long-term disease-free status (15% vs 23%) was detected between groups A and B. The initial tumour relapse was shifted towards extrahepatic sites in group-A patients, but no difference was obtained regarding the definite distribution of recurrent disease. CONCLUSION: Routine application of adjuvant regional chemotherapy after R0 liver resection is not warranted.
RCT Entities:
BACKGROUND AND AIMS: The liver represents the predominant site of cancer relapse after curative resection of hepatic metastases from colorectal carcinoma. Adjuvant intra-arterial chemotherapy was therefore considered a promising therapeutic approach in high-risk patients. PATIENTS/ METHODS: From July 1984 to December 1985, a total of 42 consecutive patients underwent R0 resection of colorectal liver metastases. Thirty patients with mesenteric lymph-node metastases (Dukes C) were randomised into two groups. In 14 group-A patients, a hepatic artery port catheter was placed during liver resection. Four courses of adjuvant chemotherapy were administered at 4-week intervals, consisting of mitomycin C (8 mg/m2, day 1) and 5-fluorouracil (800 mg/m2, days 1-5). Sixteen group-B patients served as controls. The 12 patients with no mesenteric lymph-node metastases (Dukes A/B) were included in the follow-up program. RESULTS: After 5 years, 64% of Dukes A/B patients and 29% of Dukes C patients were alive (P<0.01). The probability of remaining free of recurrent disease after 5 years and 10 years was 55% and 18%, respectively (P<0.01). No significant difference in either 5-year survival (25% vs 31%) or long-term disease-free status (15% vs 23%) was detected between groups A and B. The initial tumour relapse was shifted towards extrahepatic sites in group-A patients, but no difference was obtained regarding the definite distribution of recurrent disease. CONCLUSION: Routine application of adjuvant regional chemotherapy after R0 liver resection is not warranted.
Authors: Thomas E Clancy; Elijah Dixon; Roy Perlis; Francis R Sutherland; Michael J Zinner Journal: J Gastrointest Surg Date: 2005-02 Impact factor: 3.452
Authors: John S Bolton; Michael J O'Connell; Michelle R Mahoney; Gist H Farr; Tom R Fitch; William J Maples; David M Nagorney; Joseph Rubin; Jyotsna Fuloria; Preston D Steen; Steven R Alberts Journal: Clin Colorectal Cancer Date: 2011-05-13 Impact factor: 4.481
Authors: Martina Wieser; Stefan Sauerland; Dirk Arnold; Wolff Schmiegel; Anke Reinacher-Schick Journal: BMC Cancer Date: 2010-06-21 Impact factor: 4.430
Authors: Marc Ychou; David Azria; Cathy Menkarios; Patrick Faurous; François Quenet; Bernard Saint-Aubert; Philippe Rouanet; Monique Pèlegrin; Caroline Bascoul-Mollevi; Dominique Guerreau; Jean-Claude Saccavini; Jean-Pierre Mach; Jean-Claude Artus; André Pèlegrin Journal: Clin Cancer Res Date: 2008-06-01 Impact factor: 12.531