Recurrence In Colorectal Cancer Patients Research Articles

Longterm effects of hepatic arterial interleukin-2–based immunochemotherapy after potentially curative resection of colorectal liver metastases

Background: Our previous study of hepatic arterial infusion of interleukin-2 (IL-2)–based immunochemotherapy demonstrated a high response rate of patients with unresectable liver metastases. In this study, we applied this therapy to the prevention of liver recurrence in patients who underwent potentially curative resection of liver metastases. Study Design: A pilot study was conducted of 18 patients with liver metastases from primary colorectal cancer who underwent potentially curative liver resection followed by adjuvant immunochemotherapy. The regimen consisted of a weekly hepatic arterial infusion of IL-2 (1.4–2.1 × 10 6 U) and 5-fluorouracil (250 mg) and a bolus of mitomycin C (2–4 mg) for 6 months. Results: Among 18 patients, 14 are still alive with a median postoperative survival of 52 months (as of April 1998). The 5-year overall survival rate was 75%. Although recurrent cancer developed in 6 of the 18 patients, no patients had recurrence in the residual liver. This complete prevention of liver recurrence is believed to have contributed to the high 5-year survival rate (75%) as compared with the survival rate of patients treated with surgery alone (average, 30%–40%) or with several other forms of adjuvant therapy. Conclusions: Interleukin-2–based immunochemotherapy is useful in combination with liver resection for the prevention of liver recurrence in colorectal cancer patients with liver metastases. A multicenter randomized trial is recommended.

Predicting recurrence in colorectal cancer patients

Predicting recurrence in colorectal cancer patients

The usefulness and limitations of CEA assay in the management of colorectal cancer.

We investigated the usefulness and limitations of the measurement of CEA in the evaluation of tumor resection and the detection of recurrence in colorectal cancer patients. Preoperatively, 46 of 90 patients (51.1%) had CEA values of 5.0 ng/ml or higher. The percentage of patients with elevated CEA in whom the CEA values returned to normal one month postoperatively was significantly higher in those who had undergone a curative resection than in those who had undergone a non-curative resection (p less than 0.02). Among patients with normal CEA values, the changes were nil or only slight in CEA values, one month postoperatively. Among 28 with recurrences, 24 (85.7%) had CEA values of 5.0 ng/ml or higher. All 11 with liver recurrences had values of 10.0 ng/ml or higher. In 4 with liver recurrences and in cases where CEA measurements were made, CEA values were found to be abnormal 3 to 10 months before the recurrences and a rapid elevation occurred for a short period. However, 4 out of 10 with local or lymphnode recurrences showed normal CEA values. CEA measurement was useful in detection of liver recurrences, but not so useful in detecting local or lymphnode recurrences.