ABSTRACT
BACKGROUND/AIMS: Colon cancer is one of the major health problems in industrialized countries, and its incidence appears to be increasing. Surgical resectability is the most important prognostic determinant, although despite apparently curative surgery, recurrent tumors are common. Metastatic disease cannot be cured, and thus, there is a need for better adjuvant therapies. METHODS: Two hundred and thirty-nine patients with surgically resected colon cancer in Dukes' stage B2 or C were randomly assigned to chemotherapy or observation alone to determine whether adjuvant chemotherapy could effectively reduce the rate of cancer recurrence. One hundred and twenty-one patients in stage B2 and 118 patients in stage C were enrolled in the study. Adjuvant treatment consisted of folinic acid 200 mg/m2, intravenously, plus 5-fluorouracil 400 mg/m2, intravenously, on days 1-5 every 4 weeks for 12 cycles. RESULTS: In stage B2, no significant difference between the adjuvant arm and the observation arm was noted. In stage C, adjuvant chemotherapy produced an advantage over observation in terms of a reduction in cancer recurrence rate with prolongation of a disease-free interval (P = 0.0016) and an improvement in overall survival (P = 0.0025). CONCLUSIONS: This study shows that folinic acid plus 5-fluorouracil adjuvant chemotherapy is effective in patients with surgically resected Dukes' stage C colon carcinoma.
Subject(s)
Colonic Neoplasms/drug therapy , Fluorouracil/therapeutic use , Leucovorin/therapeutic use , Chemotherapy, Adjuvant , Colonic Neoplasms/mortality , Colonic Neoplasms/pathology , Female , Fluorouracil/adverse effects , Follow-Up Studies , Humans , Leucovorin/adverse effects , Male , Middle Aged , Neoplasm Recurrence, Local , Neoplasm Staging , Survival AnalysisABSTRACT
During the diagnostic lymphangiography of the lower limbs, the motility of the lymph vessels was investigated in 79 consecutive patients, by means of a particularly performed serial radiography, aided by photographic magnification of films. Because of technical difficulties, a rather high incidence of imperfect examinations occurred. In 26 out of 35 (74.3%) technically satisfactory observations obtained from patients with no obstacle to lymph flow, evident morphological modifications were demonstrated, surely caused by intrinsic spontaneous contractility. Only in few cases a contractile activity, somehow resembling a true peristaltic wave could be demonstrated; usually the lymphatic "pulse" appeared irregular and greatly varying and no specific rhythm was detected. Our findings suggest that: intrinsic contractility may be an important determinant of lymph flow; the pattern of contractility is strongly influenced by the anatomical feature of the lymphatic chain, whose lymphangions (intervalve segments), appear continuously varying in size and shape.
