Skip to main content
Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 1995 Mar;77(2):81–84.

Adjuvant chemotherapy for colorectal cancer.

Z Rayter 1, R J Leicester 1, J L Mansi 1
PMCID: PMC2502123  PMID: 7793820

Abstract

Colorectal cancer is the second most common cancer in the Western world, and yet the survival after potentially curative excisional surgery has improved little over the last half century. Newer tumour prognostic markers are not superior to conventional Dukes' staging and there are currently no markers which predict response to chemotherapy. Adjuvant chemotherapy has had a chequered past, but recently a number of important prospective studies have demonstrated its proven benefit in patients with Dukes' stage C colorectal cancer. However, several issues still require clarification. (1) Do immunomodulators such as levamisole have a significant role in adjuvant chemotherapy? (2) Which patients derive most benefit from adjuvant chemotherapy? (3) Do prognostic markers have a role in predicting these patients? Approximately 30% of patients with Dukes' stage B cancers die of metastatic disease and the role of adjuvant chemotherapy in patients with these tumours seems worth exploring. Only a large randomised trial can give answers to these important questions. Such a trial would also encourage the widespread introduction of standard methods of surgical and pathological assessment.

Full text

PDF
81

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abulafi A. M., Williams N. S. Local recurrence of colorectal cancer: the problem, mechanisms, management and adjuvant therapy. Br J Surg. 1994 Jan;81(1):7–19. doi: 10.1002/bjs.1800810106. [DOI] [PubMed] [Google Scholar]
  2. Archer S. G., Gray B. N. Vascularization of small liver metastases. Br J Surg. 1989 Jun;76(6):545–548. doi: 10.1002/bjs.1800760607. [DOI] [PubMed] [Google Scholar]
  3. Buyse M., Zeleniuch-Jacquotte A., Chalmers T. C. Adjuvant therapy of colorectal cancer. Why we still don't know. JAMA. 1988 Jun 24;259(24):3571–3578. [PubMed] [Google Scholar]
  4. De Brabander M., De Crée J., Vandebroek J., Verhaegen H., Janssen P. A. Levamisole in the treatment of cancer: anything new? (Review). Anticancer Res. 1992 Jan-Feb;12(1):177–187. [PubMed] [Google Scholar]
  5. Fielding L. P., Hittinger R., Grace R. H., Fry J. S. Randomised controlled trial of adjuvant chemotherapy by portal-vein perfusion after curative resection for colorectal adenocarcinoma. Lancet. 1992 Aug 29;340(8818):502–506. doi: 10.1016/0140-6736(92)91708-g. [DOI] [PubMed] [Google Scholar]
  6. Fisher B., Redmond C., Dimitrov N. V., Bowman D., Legault-Poisson S., Wickerham D. L., Wolmark N., Fisher E. R., Margolese R., Sutherland C. A randomized clinical trial evaluating sequential methotrexate and fluorouracil in the treatment of patients with node-negative breast cancer who have estrogen-receptor-negative tumors. N Engl J Med. 1989 Feb 23;320(8):473–478. doi: 10.1056/NEJM198902233200801. [DOI] [PubMed] [Google Scholar]
  7. Gordon N. L., Dawson A. A., Bennett B., Innes G., Eremin O., Jones P. F. Outcome in colorectal adenocarcinoma: two seven-year studies of a population. BMJ. 1993 Sep 18;307(6906):707–710. doi: 10.1136/bmj.307.6906.707. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Greenson J. K., Isenhart C. E., Rice R., Mojzisik C., Houchens D., Martin E. W., Jr Identification of occult micrometastases in pericolic lymph nodes of Duke's B colorectal cancer patients using monoclonal antibodies against cytokeratin and CC49. Correlation with long-term survival. Cancer. 1994 Feb 1;73(3):563–569. doi: 10.1002/1097-0142(19940201)73:3<563::aid-cncr2820730311>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  9. Jass J. R., Love S. B., Northover J. M. A new prognostic classification of rectal cancer. Lancet. 1987 Jun 6;1(8545):1303–1306. doi: 10.1016/s0140-6736(87)90552-6. [DOI] [PubMed] [Google Scholar]
  10. Mansour E. G., Gray R., Shatila A. H., Osborne C. K., Tormey D. C., Gilchrist K. W., Cooper M. R., Falkson G. Efficacy of adjuvant chemotherapy in high-risk node-negative breast cancer. An intergroup study. N Engl J Med. 1989 Feb 23;320(8):485–490. doi: 10.1056/NEJM198902233200803. [DOI] [PubMed] [Google Scholar]
  11. Moertel C. G., Fleming T. R., Macdonald J. S., Haller D. G., Laurie J. A., Goodman P. J., Ungerleider J. S., Emerson W. A., Tormey D. C., Glick J. H. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med. 1990 Feb 8;322(6):352–358. doi: 10.1056/NEJM199002083220602. [DOI] [PubMed] [Google Scholar]
  12. Nakamori S., Ota D. M., Cleary K. R., Shirotani K., Irimura T. MUC1 mucin expression as a marker of progression and metastasis of human colorectal carcinoma. Gastroenterology. 1994 Feb;106(2):353–361. doi: 10.1016/0016-5085(94)90592-4. [DOI] [PubMed] [Google Scholar]
  13. Rayter Z. Steroid receptors in breast cancer. Br J Surg. 1991 May;78(5):528–535. doi: 10.1002/bjs.1800780506. [DOI] [PubMed] [Google Scholar]
  14. Rayter Z., Surtees P., Tildsley G., Corbishley C. The prognostic value of argyrophil nucleolar organiser regions (AgNORs) in colorectal cancer. Eur J Surg Oncol. 1992 Feb;18(1):37–40. [PubMed] [Google Scholar]
  15. Remvikos Y., Tominaga O., Hammel P., Laurent-Puig P., Salmon R. J., Dutrillaux B., Thomas G. Increased p53 protein content of colorectal tumours correlates with poor survival. Br J Cancer. 1992 Oct;66(4):758–764. doi: 10.1038/bjc.1992.352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Taylor I., Machin D., Mullee M., Trotter G., Cooke T., West C. A randomized controlled trial of adjuvant portal vein cytotoxic perfusion in colorectal cancer. Br J Surg. 1985 May;72(5):359–363. doi: 10.1002/bjs.1800720509. [DOI] [PubMed] [Google Scholar]
  17. Wolmark N., Rockette H., Fisher B., Wickerham D. L., Redmond C., Fisher E. R., Jones J., Mamounas E. P., Ore L., Petrelli N. J. The benefit of leucovorin-modulated fluorouracil as postoperative adjuvant therapy for primary colon cancer: results from National Surgical Adjuvant Breast and Bowel Project protocol C-03. J Clin Oncol. 1993 Oct;11(10):1879–1887. doi: 10.1200/JCO.1993.11.10.1879. [DOI] [PubMed] [Google Scholar]
  18. Wolmark N., Rockette H., Wickerham D. L., Fisher B., Redmond C., Fisher E. R., Potvin M., Davies R. J., Jones J., Robidoux A. Adjuvant therapy of Dukes' A, B, and C adenocarcinoma of the colon with portal-vein fluorouracil hepatic infusion: preliminary results of National Surgical Adjuvant Breast and Bowel Project Protocol C-02. J Clin Oncol. 1990 Sep;8(9):1466–1475. doi: 10.1200/JCO.1990.8.9.1466. [DOI] [PubMed] [Google Scholar]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England

RESOURCES