Adjuvant portal-vein infusion of fluorouracil and heparin in colorectal cancer: a randomised trial

Rougier, Philippe; Sahmoud, Tarek; Nitti, Donato; Curran, Desmond; Doci, Roberto; Waele, Boudewijn De; Nakajima, Toshifusa; Rauschecker, H.; Labianca, Roberto; Pector, Jean Claude; Apolone, Giovanni; Lasser, P; Couvreur, M.L.; Wils, J.; Marsoni, Silvia

doi:10.1016/s0140-6736(97)08169-5

Cited by 75 publications

(14 citation statements)

References 18 publications

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“…More recently Irinotecan (CPT‐11) has been approved for use in non‐resectable colorectal liver metastases as a second line treatment, but no data supporting its use in an adjuvant setting have yet been published. Similarly, oxaliplatin and raltitrexed (Tomudex) have been licensed for use in advanced colorectal cancer [135–137], but their role in an adjuvant setting has not yet been addressed.…”

Section: Adjuvant Chemotherapymentioning

confidence: 99%

Management of colorectal liver metastases

Fusai

Davidson

2003

Colorectal Disease

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Hepatic metastases occur in 60% of patients following resection for colorectal cancer. Liver resection is the only curative option, with one third of resected patients alive at five years. In those developing recurrence in the liver following resection, further liver surgery may be curative, with similar 5 years survival rates of about 30%. Until recently surgery was feasible in only 15-25% of patients with colorectal liver metastases. New strategies, such as downstaging chemotherapy, portal vein embolization and two-stage hepatectomy, may increase the resectability rate by 15%. Earlier detection of liver metastases would increase resectability, although good follow-up trials are lacking. Once suspected, colorectal liver metastases are staged by spiral CT, CT portography and MRI, which have similar overall accuracies. Mortality following liver resection is less than 5% in major centres, with a morbidity rate of 20% to 50%. Prognostic scoring systems can be used to predict the likely cure rate with resection. Pulmonary metastases occur in 10-25% of patients with resected colorectal cancer, but are limited to the lung in only 2% of cases. In these selected cases surgery provides long-term survival in 20-40%, and repeat lung resection has shown similar rates. For patients with unresectable disease, chemotherapy and ablation techniques have been demonstrated to prolong survival, although chemotherapy alone has been shown to improve quality of life.

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Section: Adjuvant Chemotherapymentioning

confidence: 99%

Management of colorectal liver metastases

Fusai

Davidson

2003

Colorectal Disease

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“…The liver may be the initial stop for metastatic spread through the portal vein, and early postoperative regional administration of chemotherapeutic agents into the portal vein might be particularly beneficial, destroying suspected tumor cells in the liver before established tumor growth can take place. However, from 1980 until the 1990s, several randomized trials failed to show significant differences in the survival benefit between portal vein infusion and systemic chemotherapy after curative surgery for advanced CRC [18–20]. …”

Section: Hai Chemotherapy For Crcmentioning

confidence: 99%

Advances and directions in chemotherapy using implantable port systems for colorectal cancer: a historical review

Inoue

Kusunoki

2013

Surg Today

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With the recent advances in chemotherapy for colorectal cancer, the prognosis for patients with metastatic colorectal cancer has been significantly improved. The development of the implantable port system has also enabled patients to receive multiagent chemotherapy with a more satisfactory quality of life. Historically, chemotherapy using implantable port systems was begun to obtain an oncological benefit in the treatment of locoregional cancer. In the 1950s, there was an increasing interest in perfusion techniques for the application of chemotherapeutic agents, such as nitrogen mustard, in the locoregional treatment of metastatic cancer. Among them, the treatment of liver metastasis has interested oncologists for many years. On the other hand, implantable devices were developed during the intervening decades that have enabled patients with colorectal cancer with liver metastases to be treated effectively using hepatic arterial infusion; which became more common in the 1980s. The treatment of metastatic colorectal cancer increasingly requires a multimodal approach and multiple treatment options based not on convenience, but in terms of personalization and efficacy. Therefore, it is important to optimize the pharmacokinetics of chemotherapeutic agents. Implantable port systems for colorectal cancer patients have been essential for oncological practice, and the importance of these systems will remain unchanged in the near future.

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“…The four most recent, large, multicenter trials of portal vein infusion (EORTC; Swiss Group for Clinical Cancer Research; UK Coordinating Committee on Cancer Research; Studio Multicentrico Adjuvante Colon) [144][145][146][147] have not shown any survival advantage for portal vein infusion in patients with resected colon cancer.…”

Section: Intraperitoneal/intraportal Chemotherapymentioning

confidence: 99%

Practice Parameters for Colon Cancer

Otchy

Hyman

Simmang

et al. 2004

Diseases of the Colon &Amp; Rectum

137

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The American Society of Colon and Rectal Surgeons is dedicated to assuring high quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Standards Committee is composed of Society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This committee was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus. This is accomplished by developing Clinical Practice Guidelines based on the best available evidence. These guidelines are inclusive and not prescriptive. Their purpose is to provide information on which decisions can be made, rather than dictate a specific form of treatment. These guidelines are intended for the use of all practitioners, health care workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

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Adjuvant portal-vein infusion of fluorouracil and heparin in colorectal cancer: a randomised trial

Cited by 75 publications

References 18 publications

Management of colorectal liver metastases

Management of colorectal liver metastases

Advances and directions in chemotherapy using implantable port systems for colorectal cancer: a historical review

Practice Parameters for Colon Cancer

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