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Chemo After Surgery for Colon Cancer Improves Survival

Fluorouracil, folinic acid reduces mortality, recurrence

FRIDAY, Dec. 14 (HealthDay News) -- Chemotherapy with fluorouracil and folinic acid reduces the risk of mortality and recurrence in patients with stage II colorectal cancer after apparently curative surgery, according to a study in the Dec. 15 issue of The Lancet.

Richard Gray, from the University of Birmingham in the United Kingdom, and colleagues randomly assigned 3,239 patients with colorectal cancer who had apparently curative resections of colon or rectal cancer to chemotherapy with fluorouracil and low- or high-dose folinic acid, or observation (with possible chemotherapy on recurrence). The study took place from 1994-2003, and patients treated with chemotherapy until 1997 were also given placebo or levamisole, while after 1997 chemotherapy patients were given only fluorouracil and low-dose folinic acid.

After a median follow-up of 5.5 years, the researchers observed a significant reduction in mortality in the chemotherapy group (311 versus 370 deaths, relative risk 0.82). The risk of recurrence was also significantly lower in the chemotherapy group (293 versus 359, relative risk 0.78).

"Chemotherapy with fluorouracil and folinic acid could improve survival of patients with stage II colorectal cancer, although the absolute improvements are small: assuming five-year mortality without chemotherapy is 20 percent, the relative risk of death seen here translates into an absolute improvement in survival of 3.6 percent," Gray and colleagues conclude.

Authors of this study have disclosed relationships with Roche, Sanofi and Merck.

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