[Neoadjuvant chemotherapy for recurrent colorectal cancer]

The prognosis after surgical resection of recurrent colorectal cancer is still poor, even if it is diagnosed as "resectable" before operation. Neoadjuvant chemotherapy (NAC) may reduce the recurrence rate after resection of recurrent lesions by ensuring the surgical margin and controlling micro-metastases. This report presents the treatment regimen and outcome of NAC for recurrent colorectal cancer at this institution.

Nineteen patients with recurrent colorectal cancer, excluding hepatic and pulmonary metastases, received NAC before laparotomy between April 2005 and November 2011. The FOLFIRI3 regimen combined with molecular targeting agents was used for NAC, and 4 to 8 courses were administered. Laparotomy was performed during the 4-to 6-week period after the last NAC administration, and 12 courses of mFOLFOX6 were recommended as adjuvant chemotherapy after the operation.

Complete remission was observed in 1 patient and partial remission in 7 patients according to Response Evaluation Criteria in Solid Tumors ver. 3, and no progressive disease was observed. Curative resection was achieved in 13 patients. The 3-year overall survival rate was 83.6%, and the 3-year relapse-free survival rate was 50.3%.

This retrospective study using a small number of subjects suggested that NAC for recurrent colorectal cancer may increase the curative resection rate while reducing the recurrence rate.