Pre- and post-operative adjuvant chemotherapy in colorectal cancer

A multi-center randomized controlled study was conducted in order to investigate the usefulness of pre- and post-operative adjuvant chemotherapy in colorectal cancer. The patients were stratified into those with colon cancer and those with rectal cancer and divided into 2 groups, Group A and Group B. The patients in Group A received tegafur suppositories (750 mg/day) from 1 to 2 weeks prior to surgery, to 2 weeks following surgery and then oral administration of tegafur and uracil (UFT) (260 mg/m(2)) for 1 year. The patients in Group B, on the other hand, received only UFT (260 mg/m(2)) for 1 year beginning week 2 after surgery. Although there was no significant difference between Groups A and B in the 5-year survival rate, the 5-year disease-free survival rate was significantly higher in Group A, especially for rectal cancer (p<0.05). In addition, remote metastases tended to be suppressed for both colon and rectal cancer in Group A (p=0.08 and p=0.072). There was no serious adverse reaction to tegafur. Pre- and post-operative adjuvant chemotherapy with tegafur had fewer adverse reactions and was convenient to administer. Thus, it was considered useful for suppression of postoperative distant metastasis in colorectal cancer.