Clinical Impact of Adjuvant Chemotherapy on Patients with Stage III Colorectal Cancer: l-LV/5FU Chemotherapy as a Modified RPMI Regimen is an Independent Prognostic Factor for Survival

Abstract

Background: Patients with stage III colorectal cancer have a substantial risk of microscopic metastatic disease at the time of resection. Treatment with leucovorin (LV)/5-Fluorouracil (5FU) has been demonstrated to be effective for advanced colorectal cancer; however, the clinical impact of l-LV/5FU is still unclear. l-LV/5FU for patients with stage III colorectal cancer may play an important role, as an adjuvant chemotherapy, in improving survival. Patients and Methods: The clinicopathological features of 36 patients receiving adjuvant l-LV/54 administration and 16 not, univariate analysis of potential predictors of overall survival and disease-free survival, relative risk of overall survival and disease-free survival by multivariate analysis and the occurrence of chemotherapy-induced toxic effects were studied in 52 patients with stage III colorectal cancer, including 30 with rectal and 22 with colon cancer, who had undergone surgery. Results: No significant differences were found in the clinicopathological features of the 2 groups. On univariate analysis, there were no significant differences in overall survival in either group; disease-free survival in patients with adjuvant l-LV/5FU was longer than that in patients without it (p<0.001). Moreover, multivariate analysis demonstrated that l-LV/5FU adjuvant chemotherapy was an independent prognostic factor in terms of disease-free survival (p=0.001; RR, 17.492; 95% CI, 3.298-92.778). Conclusion: l-LV/5FU adjuvant chemotherapy in patients with stage III colorectal cancer is important as an independent prognostic factor in terms of disease-free survival.