Anticancer effects of preoperative chemotherapy on colorectal carcinoma

This study was designed to evaluate the efficacy of preoperative chemotherapy and to investigate the relationship between the histopathologic response and prognosis in patients with colorectal carcinoma. Thirty-six previously untreated patients with advanced colorectal carcinoma were consecutively enrolled in this study and received preoperative N-(2-tetrahydrofuryl-5-fluorouracil (FT-207) by suppository. The histopathologic response was investigated. Histopathologically, 14 patients had no response, 19 responded slightly, 2 moderately and 1 had a complete response to the chemotherapy. The extent of the histopathologic response to chemotherapy was greater in the deeper layers of the invaded tissue. There was no relation between the location of the tumor and the extent of the histopathologic response. Based on clinical cancer staging, the overall 5-year survival rate was 100% in patients with Duke's A and Duke's B cancer and 45% in patients with Duke's C cancer; the 3-year survival rate was 25% in patients with Duke's D cancer. The 5-year survival rate for those with a positive histopathologic response to chemotherapy was 71%, whereas that for the nonresponders was 79%. Mild chemotherapy in the form of FT-207 suppositories was found to be effective histopathologically. However, no relationship was seen between the histopathologic response and survival rate.