[Reevaluation of intraluminal fluorouracil chemotherapy as an adjuvant to radical resection of colorectal cancer--results of a randomized trial]

Abstract

Eighty-two patients with colo-rectal cancers (29 colon and 53 rectum) were admitted and underwent radical resection from January 1982 to June 1984. There were 54 males and 28 females. The ages ranged from 25 to 74 years. According to Dukes's classification, there were 2 Stage A, 47 (57.3%) Stage B and 33 (40.2%) Stage C. Histologically, 70.7% were adenocarcinoma, 20.7% mucinous carcinoma and 8.6% others. All these patients were randomized into two groups: trial group and control group. In the trial group, there were 45 patients treated by radical resection plus adjuvant intraluminal 5-FU chemotherapy and intravenous 5-FU chemotherapy on the first and second days postoperatively. The intraluminal dose of 5-FU was 30 mg/kg injected into the bowel lumen of the isolated diseased segment between the tape ligatures. The intravenous dose was 10 mg/kg given on the first and second days after operation. In the control group, there were 37 patients treated by radical resection alone. The survival rates were calculated by the life-table method and the results showed that in patients with Dukes' C, the 5-year survival rate of the trial group was 61.8%, and that of the control group was 27.3% (P less than 0.05). In addition, hepatic metastasis in the trial group was less than that in the control group. The results of the randomized trial indicated that adjuvant intraluminal 5-FU chemotherapy may be an important approach to improve the results of radical resection for advanced colo-rectal cancer and to prevent hepatic metastases. Further clinical studies are recommended.