Medium-term results of neoadjuvant systemic chemotherapy using irinotecan, 5-fluorouracil, and leucovorin in patients with locally advanced rectal cancer

Ishii, Yoshiyuki; Hasegawa, Hiroko; Endo, Takeshi; Okabayashi, Koji; Ochiai, Hiroki; Moritani, Konosuke; Watanabe, Masahiko; Kitagawa, Yuko

doi:10.1016/j.ejso.2010.05.017

Cited by 61 publications

(32 citation statements)

References 35 publications

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“…The completion rate for total mesorectal excision, which is regarded as a quality control for rectal surgery, was significantly associated with a reduction in postoperative local recurrence [13,14]. Our previous study reporting the use of neoadjuvant chemotherapy in patients with advanced rectal cancer also demonstrated that preoperative chemotherapy had no impact on the prevention of local recurrence despite obvious tumor shrinkage in 46% of the participants [15]. Given the molecular mechanism and biases originating from the inclusion of patients with rectal cancer, a well-controlled study focusing on colon cancer may clarify the impact of the preoperative administration of tegafur suppositories on the reduction of distant metastasis, which might lead to the development of a novel strategy for advanced colon cancer.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of the Preoperative Administration of Tegafur Suppositories as Alternative Adjuvant Chemotherapy for Patients with Resectable Stage II or III Colorectal Cancer: A KODK4 Multicenter Randomized Control Trial

et al. 2012

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Objective: The aim of this study was to evaluate the feasibility and conferred protection against recurrence of preoperatively administered tegafur suppositories following the intravenous and oral administration of fluoropyrimidine in a multicenter randomized control trial. Methods: Patients with clinical T3/4 colorectal cancer were randomly assigned to receive the preoperative administration of tegafur suppositories (group A) or no preoperative treatment (group B). The primary end points were disease-free survival (DFS) and overall survival (OS). Results: The mean follow-up periods were 80.9 ± 31.0 months in group A and 64.5 ± 28.8 months in group B. The 5-year DFS rates were 89.3% in group A and 70.3% in group B (p = 0.045), whereas the 5-year OS rates were 91.4% in group A and 73.2% in group B (p = 0.051). Furthermore, a significant difference in the cumulative distant metastatic rate was observed (group A, 7.4% vs. group B, 23.4%; p = 0.03). However, no significant difference in the cumulative local recurrence rate was seen (group A, 4.6% vs. group B, 8.2%; p = 0.68). Conclusion: Despite a relatively small sample size, preoperative tegafur suppositories might protect recurrences and improve survival rates, mainly by preventing distant metastasis. These findings suggest the utility of tegafur suppositories as an alternative neoadjuvant treatment in modern chemotherapy for colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

Usefulness of the Preoperative Administration of Tegafur Suppositories as Alternative Adjuvant Chemotherapy for Patients with Resectable Stage II or III Colorectal Cancer: A KODK4 Multicenter Randomized Control Trial

et al. 2012

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“…Four studies [30,32,34,35] reported 100 % R0 resection rate. Despite recruiting MRI-defined poor-risk rectal cancers, the study by Uehara et al [31] achieved R0 resection in 90 % (27/30) of cases.…”

Section: R0 Resection and Postoperative Morbiditymentioning

confidence: 98%

“…Higher rate of anastomotic leak (9 %) could be due to the fact that there was no construction of defunctioning stoma for sphincter sparing surgery. Ishii et al [34] reported the lowest complication rate of 15 %. Four patients developed postoperative complications: two had anastomotic leak and two had wound infection.…”

Section: R0 Resection and Postoperative Morbiditymentioning

confidence: 98%

“…In addition, this study also included 14 patients with synchronous metastatic colon or rectal cancer treated with preoperative chemotherapy undergoing resection of primary tumour. The phase II trial by Ishii et al [34] administered 2 cycles of irinotecan, 5-fluorouracil and leucovorin (IFL) neoadjuvant chemotherapy to T3-T4 and or N+ patients. In the trial by Ohwada et al [35], neoadjuvant chemotherapy was administered in the form of tegafur suppositories-a pro-drug of 5-fluorouracil.…”

Section: Characteristics Of the Patients Included In The Studiesmentioning

confidence: 99%

“…Compliance reported by five studies ranged from 72 % [32] to 100 % [34]. For the randomised trial [28], a completion rate of 5-FU continuous infusion was 96.8 %.…”

Section: Compliancementioning

confidence: 99%

See 2 more Smart Citations

Review of Neoadjuvant Chemotherapy Alone in Locally Advanced Rectal Cancer

Jalil

Claydon

Arulampalam

2015

J Gastrointest Canc

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Total neoadjuvant therapy in locally advanced rectal cancer: Role of systemic chemotherapy

Yoo

Kim

2019

Annals of Gastroent Surgery

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For the past several decades, disease‐related outcomes, particularly local recurrence rate, in patients with locally advanced rectal cancer have significantly improved as a result of advancement of surgical technique and implementation of neoadjuvant chemoradiation. However, distant metastasis remains unresolved, being a significant cause of cancer death. To focus on micrometastases early in the course of multimodal treatment, delivering systemic chemotherapy in the neoadjuvant setting is emerging. Also, driven by patient demand and interest in preserving quality of life, upfront chemotherapy prior to surgery serves as a strategy for organ preservation in the management of rectal cancer. Herein, currently available literature on different methods and strategies of the multimodal approach is critically appraised.

show abstract

Medium-term results of neoadjuvant systemic chemotherapy using irinotecan, 5-fluorouracil, and leucovorin in patients with locally advanced rectal cancer

Cited by 61 publications

References 35 publications

Usefulness of the Preoperative Administration of Tegafur Suppositories as Alternative Adjuvant Chemotherapy for Patients with Resectable Stage II or III Colorectal Cancer: A KODK4 Multicenter Randomized Control Trial

Usefulness of the Preoperative Administration of Tegafur Suppositories as Alternative Adjuvant Chemotherapy for Patients with Resectable Stage II or III Colorectal Cancer: A KODK4 Multicenter Randomized Control Trial

Review of Neoadjuvant Chemotherapy Alone in Locally Advanced Rectal Cancer

Total neoadjuvant therapy in locally advanced rectal cancer: Role of systemic chemotherapy

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