Biomedical subjects

U Laffer

Publications and source records attributed to U Laffer.

57 records · Page 4Linked to original sources

PubMedDate not supplied

Randomized multicenter trial of adjuvant intraportal chemotherapy for colorectal cancer (SAKK 40/81). An interim report.

A prospective, randomized trial of adjuvant portal infusion of 5-fluorouracil in combination with mitomycin C was conducted on 469 patients with operable colorectal cancer. A single postoperative course of the cytotoxic agents was compared with radical surgery alone. The actuarial 5-year survival (median follow-up 48 months) was 70 +/- 3% in the chemotherapy group and 57 +/- 4% in the control group (p = 0.10). The respective figures for disease-free survival were 62 +/- 4% and 53 +/- 4% (p = 0.09). Among the 195 cases with strict adherence to the protocol for adjuvant chemotherapy there were 59 recurrences and 44 deaths in the follow-up period, whereas in the 274 with no or incomplete chemotherapy there were 120 recurrences and 99 deaths (p less than 0.05). Perioperative adjuvant chemotherapy via portal infusion proved to be feasible in a multicenter setting. Follow-up will be continued, in order to provide definitive information on survival according to randomization.

Adenocarcinoma↗

PubMedDate not supplied

Adjuvant portal liver infusion with 5-fluorouracil and mitomycin in colorectal cancer. SAKK.

Between 1981 and 1987, 533 patients from 9 institutions were entered in a randomized trial to assess the value of adjuvant perioperative portal infusion with Fluorouracil and Mitomycin as compared to radical surgery alone. Analysis of 469 evaluable patients at a median follow-up of 5.8 years revealed 110 recurrences in the control and 94 recurrences in the infusion group. Estimated 5-year disease-free survival was 52% and 61% respectively (hazard ratio: 1:0.75; 95% confidence interval 0.57-0.99; p = 0.046). Overall survival was 59% in the control and 69% in the infusion group (p = 0.048). Adjuvant portal infusion did not influence the occurrence of liver metastases but reduced the overall recurrence rate.

Colorectal Neoplasms↗

PubMedDate not supplied

Early hematological toxicity of adjuvant perioperative intraportal and intravenous chemotherapy with fluorouracil, mitomycin and heparin in colorectal cancer. Swiss Group for Clinical Cancer Research.

BACKGROUND: From 1987 to 1993 the Swiss Group for Clinical Cancer Research (SAKK) performed a randomized phase III adjuvant trial in patients with colorectal adenocarcinoma with the objective of comparing intraportal versus intravenous perioperative chemotherapy. PATIENTS AND METHODS: Patients younger than 75 years had a curative en bloc resection of their cancer and were then randomized into three arms: 1. adjuvant perioperative portal liver infusion with fluorouracil, mitomycin and heparin, 2. adjuvant subclavian intravenous infusion with the same regimen and 3. no adjuvant treatment. The hematological toxicity was evaluated by hemoglobin determination and leucocyte and thrombocyte counting before and during ten days after surgery. RESULTS: Hemoglobin showed a median decrease of 22% in the control group. This decrease is aggravated significantly by 3% through the chemotherapy. Leucocytes showed a median decrease of 7% in the control group. Perioperative chemotherapy caused a significantly higher median drop; 23% when given into the liver through the portal vein and 34% when given systemically through a subclavian catheter. Thrombocytes revealed a median decrease of 25% in the control group. Chemotherapy was not associated with a significant additional drop. CONCLUSIONS: Adjuvant perioperative chemotherapy with fluorouracil, mitomycin and Heparin as given in this study is associated with a significant mild drop in hemoglobin and leucocytes during the first 10 postoperative days. If drug dose increases are planned in future trials the addition of hematopoietic growth factors might be considered.

Antineoplastic Combined Chemotherapy Protocols↗