Postoperative adjuvant irradiation and 5-fluorouracil for adenocarcinoma of the cecum. A pilot study.

Twenty-one patients with adenocarcinoma of the cecum were treated in a pilot study between October, 1972 and June, 1982 by right hemicolectomy and received adjuvant postoperative irradiation (40-45 Gy/4-5 weeks) and 5-Fluorouracil (5-FU). There were 15, 4, and 2 patients with Stages (Astler-Coller) B2, C2, and D, respectively. There was no major morbidity nor mortality attributable to the adjuvant therapy. Patients were followed for a minimum of 15 months. Fifteen patients are alive and disease-free, with a median survival of 34 months (range, 17-79). There were no significant differences in the median survival or incidence of distant metastases when the adjuvant therapy group was matched by sex, age, and stage of disease with a group of patients treated by right hemicolectomy alone. There was a lower local failure rate in the adjuvant group compared with the surgery-alone group (5% versus 19%) (P less than 0.2). These data suggest that adjuvant therapy for cecal carcinoma is feasible, safe, and may reduce local failures and possibly improve survival in high-risk patients. It deserves further investigation so that a definite conclusion may be drawn.