EFFECTIVE SECONDARY NEOADJUVANT CHEMOTHER APY WITH 5-FLUOROURACIL ANDFOLINIC ACID IN A PATIENT WITH CANCER OF THE COLON

Background: Adjuvant chemotherapy of high-risk carcinomas of the colon and rectum has recently been established. However, early chemotherapy is not yet proven to have a positive influence on the resectability a rid prognosis in patients with synchronous distant metastases. Case Re port: We report on a 63-year-old patient who suffered from colon cance r with synchronous hepatic metastases. In August 1992, a left-sided he micolectomy was performed for pT3, pN1, pM1 (hepar.) G2 cancer of the descending colon. Intraoperatively 2 hepatic metastases were found. Fo llowing a postoperative chemotherapy with 5-fluorouracil (5-FU) and fo linic acid (FA) (3 cycles) a significant regression of the metastases became evident. In absence of further distant metastases and local rec urrence the potentially curative resection of the hepatic metastases w as performed successfully by segmentectomy of the segments 4 and 8 in December 1992. The postoperative course was uneventful. The histopatho logical examination showed complete necrotic and devitalized tumor tis sue. For one more year, until September 1993, adjuvant chemotherapy wi th 5-FU and FA was performed, Until now (December 1994) the patient ha s remained free. Conclusions: In carcinoma of the colon with synchrono us distant metastases the combination of 5-FU and FA might serve as a potentially successful neoadjuvant chemotherapy regimen.