aclarubicin and Colorectal-Neoplasms

Fifty-five patients with hepatic metastasis from colorectal cancer underwent curative hepatic resection. Postoperative intraportal infusion of 5-fluorouracil (500mg per day) for 14 days from 21 postoperative days (POD) and lipiodol-aclarubicin (40mg) at 35 POD was carried out in twenty-eight patients for reducing the recurrence in the remnant liver and improving the prognosis. Twenty-seven patients had hepatectomy alone as controls. Intraportal infusion chemotherapy did not induce any hepatotoxicity and hematologic severe abnormalities. The cumulative survival rates for the infusion group and the control group, respectively, were 89.3% and 63.0% at 1 year; 55.2% and 43.3% at 2 year; 27.0% and 27.5% at 3 year. The survival rate for the infusion group was significantly higher than that for the control group at 1 year (p < 0.05). No difference of the recurrent rate in the remnant liver was found between the two groups. It is suggested that intraportal infusion chemotherapy after curative hepatic resection for colorectal liver metastasis might improve survival rate at the early postoperative period. Intraportal infusion chemotherapy could be an effective adjuvant therapy especially in the patients with bilateral and multiple hepatic metastasis.

Topics: Aclarubicin; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Chemoembolization, Therapeutic; Colorectal Neoplasms; Combined Modality Therapy; Female; Fluorouracil; Hepatectomy; Humans; Infusions, Intravenous; Iodized Oil; Liver Neoplasms; Male; Middle Aged; Portal Vein; Prognosis; Survival Rate

This study explored the possibility of achieving a better survival rate and reduced recurrence in the remaining liver in patients with colorectal hepatic metastases undergoing hepatic resection. Adjuvant postoperative regional chemotherapy was administered via the hepatic artery or the portal vein.. A retrospective study was performed on 174 patients after hepatic resection for colorectal metastases. These comprised 78 patients who had hepatic artery infusion (HAI) chemotherapy (HAI group), 30 who had portal vein infusion (PVI) chemotherapy (PVI group) and 66 who had no regional chemotherapy (resection alone group). The three groups were compared with one another in terms of complications, survival rate and patterns of recurrence.. Severe complications did not occur at any point during adjuvant HAI or PVI chemotherapy. The 5-year disease-free survival rate of patients in the HAI, PVI and resection alone groups were 35, 13 and 9 per cent respectively, including six hospital deaths. Patients in the HAI group showed significantly improved recurrence rates in the remaining liver compared with the resection alone group (P = 0.03), and more prolonged disease-free and overall survival than those in the PVI (P = 0.01 and P = 0.02 respectively) and resection alone (P = 0.0001 and P = 0.0006 respectively) groups.. This study suggests that adjuvant HAI chemotherapy after hepatic resection may have therapeutic potential for improved management of patients with colorectal metastases.

Topics: Aclarubicin; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Colorectal Neoplasms; Female; Fluorouracil; Hepatectomy; Humans; Infusion Pumps; Infusions, Intra-Arterial; Infusions, Intravenous; Injections; Lipids; Liver Neoplasms; Male; Middle Aged; Mitomycin; Neoplasm Recurrence, Local; Survival Analysis

In tissues obtained from patients undergoing gastrectomy or colectomy, sensitivity to mitomycin C (MMC), carboquone (CQ), and aclacinomycin A (ACR) was examined in 20 tumors (15 gastric, 5 colorectal) and in the adjacent normal mucosal tissues, using the in vitro succinate dehydrogenase inhibition test. The succinate dehydrogenase (SD) activity decreased to a greater extent in the tumor tissues than in adjacent normal tissues, at rates of 80% for MMC, 80% for CQ, and 90% for ACR. There were no correlations between SD activities of tumor and adjacent normal tissue, r = 0.157 for MMC, r = 0.435 for CQ, and r = 0.375 for ACR. Normal tissues were sensitive to MMC in 25% of cases sensitive to MMC in the tumor tissues, 46% for CQ, and 38% for ACR. These results show that the antitumor effects of MMC, CQ, and ACR are relatively specific for tumor tissues and that the assay of chemosensitivity of normal tissues is meaningful for predicting the toxic effects of antitumor drugs on these tissues.

Topics: Aclarubicin; Azirines; Carbazilquinone; Cell Survival; Colorectal Neoplasms; Drug Screening Assays, Antitumor; Humans; In Vitro Techniques; Mitomycins; Stomach Neoplasms; Succinate Dehydrogenase; Tumor Cells, Cultured