Chemotherapy for nonresectable colorectal cancer at a center during 25 years

The aims of the present study were to assess overall survival in patients with advanced, nonresectable colorectal cancer from an individual center and to evaluate the effect of successive new chemotherapy regimens during 25 years at that center.

The medical journals of all patients with metastastic or locally advanced, nonresectable, colorectal adenocarcinoma treated at Levanger Hospital from 1980 to 2004 were retrospectively analyzed; there were a total of 465 patients.

Two hundred patients (43%) received chemotherapy while 265 did not. Estimated overall median months of survival (95% C.I.) were 4.9 (4.2-5.6) with no chemotherapy, 8.2 (5.8-10.6) with 5-FU, 9.6 (7.7-11.5) with 5-FU/LV, 10.7 (1.1-20.3) with Campto based, and 15.2 (4.5-26.0) with Oxaliplatin based regimens (p<0.001, log rank test). In a multivariate analysis, type of chemotherapy regimen and histologic differentiation of the primary tumor were associated with survival, while year of treatment and age was not. Among those who received chemotherapy, this treatment was given in the last 14 days of life in 20% of the patients during 1980-1984 compared to 4.7% during 2000-2006.

As successive new chemotherapy regimens were introduced during the 25 years, increasing overall survival was shown.