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

Philippe Rougier, Tarek Sahmoud, Donato Nitti, Desmond Curran, Roberto Doci, B. De Waele, Toshifusa Nakajima, Helmut Rauschecker, Roberto Labianca, Jean Claude Pector, Silvia Marsoni, Giovanni Apolone, Philippe Lasser, Marie Laure Couvreur, Jacques Wils

Research output: Contribution to journalArticle

Abstract

Background. There is conflicting evidence on the efficacy of regional adjuvant chemotherapy, via portal-vein infusion (PVI), after resection of colorectal cancer. We undertook a randomised controlled multicentre trial to investigate the efficacy of PVI (500 mg/m2 fluorouracil plus 5000 IU heparin daily for 7 days). Methods. 1235 of about 1500 potentially eligible patients were randomly assigned surgery plus PVI or surgery alone (control). The patients were followed up for a median of 63 months, with yearly screening for recurrent disease. The primary endpoint was survival; analyses were by intention to treat. Findings. 619 patients in the control group and 616 in the PVI group met eligibility criteria. 164 (26%) control-group patients and 173 (28%) PVI-group patients died. 5-year survival did not differ significantly between the groups (73 vs 72%; 95% CI for difference -6 to 4). The control and PVI groups were also similar in terms of disease-free survival at 5 years (67 vs 65%) and the number of patients with liver metastases (79 vs 77%). Interpretation. PVI of fluorouracil, at a dose of 500 mg/m2 for 7 days, cannot be recommended as the sole adjuvant treatment for high-risk colorectal cancer after complete surgical excision. However, these results cannot eliminate a small benefit when PVI is used at a higher dosage or in combination with mitomycin.

Original languageEnglish
Pages (from-to)1677-1681
Number of pages5
JournalLancet
Volume351
Issue number9117
DOIs
Publication statusPublished - Jun 6 1998

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Portal Vein
Fluorouracil
Heparin
Colorectal Neoplasms
Control Groups
Intention to Treat Analysis
Survival
Mitomycin
Adjuvant Chemotherapy
Multicenter Studies
Disease-Free Survival
Randomized Controlled Trials
Neoplasm Metastasis
Liver

ASJC Scopus subject areas

  • Medicine(all)

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Rougier, P., Sahmoud, T., Nitti, D., Curran, D., Doci, R., De Waele, B., ... Wils, J. (1998). Adjuvant portal-vein infusion of fluorouracil and heparin in colorectal cancer: A randomised trial. Lancet, 351(9117), 1677-1681. https://doi.org/10.1016/S0140-6736(97)08169-5

Adjuvant portal-vein infusion of fluorouracil and heparin in colorectal cancer : A randomised trial. / Rougier, Philippe; Sahmoud, Tarek; Nitti, Donato; Curran, Desmond; Doci, Roberto; De Waele, B.; Nakajima, Toshifusa; Rauschecker, Helmut; Labianca, Roberto; Pector, Jean Claude; Marsoni, Silvia; Apolone, Giovanni; Lasser, Philippe; Couvreur, Marie Laure; Wils, Jacques.

In: Lancet, Vol. 351, No. 9117, 06.06.1998, p. 1677-1681.

Research output: Contribution to journalArticle

Rougier, P, Sahmoud, T, Nitti, D, Curran, D, Doci, R, De Waele, B, Nakajima, T, Rauschecker, H, Labianca, R, Pector, JC, Marsoni, S, Apolone, G, Lasser, P, Couvreur, ML & Wils, J 1998, 'Adjuvant portal-vein infusion of fluorouracil and heparin in colorectal cancer: A randomised trial', Lancet, vol. 351, no. 9117, pp. 1677-1681. https://doi.org/10.1016/S0140-6736(97)08169-5
Rougier P, Sahmoud T, Nitti D, Curran D, Doci R, De Waele B et al. Adjuvant portal-vein infusion of fluorouracil and heparin in colorectal cancer: A randomised trial. Lancet. 1998 Jun 6;351(9117):1677-1681. https://doi.org/10.1016/S0140-6736(97)08169-5
Rougier, Philippe ; Sahmoud, Tarek ; Nitti, Donato ; Curran, Desmond ; Doci, Roberto ; De Waele, B. ; Nakajima, Toshifusa ; Rauschecker, Helmut ; Labianca, Roberto ; Pector, Jean Claude ; Marsoni, Silvia ; Apolone, Giovanni ; Lasser, Philippe ; Couvreur, Marie Laure ; Wils, Jacques. / Adjuvant portal-vein infusion of fluorouracil and heparin in colorectal cancer : A randomised trial. In: Lancet. 1998 ; Vol. 351, No. 9117. pp. 1677-1681.
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AU - Curran, Desmond

AU - Doci, Roberto

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AU - Lasser, Philippe

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N2 - Background. There is conflicting evidence on the efficacy of regional adjuvant chemotherapy, via portal-vein infusion (PVI), after resection of colorectal cancer. We undertook a randomised controlled multicentre trial to investigate the efficacy of PVI (500 mg/m2 fluorouracil plus 5000 IU heparin daily for 7 days). Methods. 1235 of about 1500 potentially eligible patients were randomly assigned surgery plus PVI or surgery alone (control). The patients were followed up for a median of 63 months, with yearly screening for recurrent disease. The primary endpoint was survival; analyses were by intention to treat. Findings. 619 patients in the control group and 616 in the PVI group met eligibility criteria. 164 (26%) control-group patients and 173 (28%) PVI-group patients died. 5-year survival did not differ significantly between the groups (73 vs 72%; 95% CI for difference -6 to 4). The control and PVI groups were also similar in terms of disease-free survival at 5 years (67 vs 65%) and the number of patients with liver metastases (79 vs 77%). Interpretation. PVI of fluorouracil, at a dose of 500 mg/m2 for 7 days, cannot be recommended as the sole adjuvant treatment for high-risk colorectal cancer after complete surgical excision. However, these results cannot eliminate a small benefit when PVI is used at a higher dosage or in combination with mitomycin.

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