IMR Press / FBE / Volume 3 / Issue 4 / DOI: 10.2741/E348

Frontiers in Bioscience-Elite (FBE) is published by IMR Press from Volume 13 Issue 2 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Article
Additional 5-FU-LV significantly increases survival in gastrointestinal cancer
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1 Department of Internal Medicine, University of Pisa, Pisa, Italy
2 Department of Surgery, University of Pisa
3 Unit of Epidemiology and Biostatistics, Institute of Clinical Physiology, CNR, Pisa, Italy
4 Department of Pathology and Laboratory Medicine, St Vincent’s University Hospital, Dublin and Conway Institute, UCD School of Medicine and Medical Science, University College, Dublin, Ireland
5 HadassahHebrew University Medical Center, Jerusalem, Israel
6 Department of Reproduction and Ageing, University of Pisa; Italy
7 Focus Groups, European Group on Tumor Markers (EGTM)

*Author to whom correspondence should be addressed.

Academic Editor: Andrea Nicolini

Front. Biosci. (Elite Ed) 2011, 3(4), 1475–1482; https://doi.org/10.2741/E348
Published: 1 June 2011
(This article belongs to the Special Issue Progress in endocrinology and related tumors)
Abstract

Metastatic colorectal and other locally advanced gastrointestinal (G.I.) cancers often recur after curative resection. Many mechanisms of tumor growth and/or immune escape by residual cancer cells may provoke tumor progression. Long-term, cytostatic action with repeated post-adjuvant administration of 5-fluorouracil (FU)-leucovorin (LV) cycles may interrupt or downregulate these mechanisms and favor the recovery and/or increase the immune system activity. Seventy patients were considered. An active prospective cohort including 21 patients (study group) was matched in a 1:1 ratio with a retrospective parallel control group of 21 patients. The study group received long-term repeated post-adjuvant administration of 5-FU-LV cycles, while the matched control group was conventionally treated. Statistical analysis was performed by Kaplan-Meier method and Cox's proportional hazard regression model. The five-year disease-free survival (DFS) was 77.0 + 10.1% and 31.7 + 10.6% (p = 0.001; hazard ratio (HR) 5.3, 95 % C.I.: 1.7-16.1, p = 0.003), while the five-year overall survival (OS) was 88.0 + 8.1% and 37.0 + 10.7% (p = 0.001; HR 8.9, 95% C.I.: 2.0-39.9, p = 0.004) in the study group and in matched controls respectively. These findings suggest a relevant improvement in the outcome of this population by an intermittent and prolonged cytostatic effect with 5-FU-LV.

Keywords
Cancer
Fluorouracil
Gastrointestinal
High Risk
Survival
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