Background
Tissue samples from patients with pathologic (p) stage III colorectal cancer were tested for sensitivity to 5-fluorouracil (5-FU).
On the basis of the results, patients were divided into 5-FU–sensitive and 5-FU–resistant
groups, and both groups were treated with fluoropyrimidine (UFT) as postoperative
adjuvant chemotherapy. Recurrence, 5-year survival rates, and 5-year recurrence-free
survival rates were compared.
Methods
The anticancer sensitivity test described in this study was carried out using tumor
samples obtained surgically from 34 patients with curatively resectable colorectal
cancer that had been diagnosed definitively as pstage III (IIIa, 23 patients; IIIb, 11 patients). Regardless of tumor sensitivity
or resistance to 5-FU, all 34 patients were subsequently treated daily with UFT at
300 mg/day as postoperative adjuvant chemotherapy. Treatment was initiated 3 weeks
after surgery and continued for 2 years.
Results
Of the 34 patients with pstage III colorectal cancer, the tumors of 16 (47%) were 5-FU–sensitive (S group)
and 18 (53%) were 5-FU–resistant (R group). The recurrence rates in the S and R groups
following postadjuvant therapy with UFT were 25% and 61%, respectively, which is a
significantly lower response in the S group (P = .045). The odds ratio of recurrence in the R group vs. the S group was 4.71. The
5-year survival rate was 85.7% in the S group and 46.7% in the R group, but the difference
was not significant (P = .066). The 5-year recurrence-free survival rate was significantly higher in the
S group than in the R groups (71% vs. 32%, P = .010). According to Cox’s multivariate analysis of recurrence-free survival, the
sensitivity test was significantly predictive.
Conclusion
Administration of UFT as postoperative adjuvant therapy to 5-FU–resistant patients
had no significant effect on outcome.
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Article info
Publication history
Accepted:
June 2,
2007
Footnotes
Supported by a grant from the Japan Science and Technology Agency’s Development Project (April 1998-March 2003).
Identification
Copyright
© 2007 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
