***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: About half the patients treated with curative resection for colorectal cancer do not survive long-term . Adjuvant chemotherapy given during and after surgery may prevent hepatic metastases and improve patient survival . In patients with colorectal cancer , we have done a multicentre , r and omised controlled trial comparing five-year survival after intraportal infusion of fluorouracil ( 1 g per day ) plus heparin ( 10,000 U per day )  ( 130 patients )  or heparin alone ( 123 ) during curative resection and for 7 days thereafter , or after resection alone ( 145 ) . There was no reduction in liver metastasis or increased overall survival advantage in either active-treatment arm of the study . However , patients who had stage III , Dukes ' C ( lymph-node-positive ) tumours resected and were treated with fluorouracil plus heparin had a significant ( p less than 0.03 ) survival advantage of about 16 % compared with surgery-only controls . Further study of intraportal infusion of chemotherapeutic agent as adjuvant treatment to surgery in patients with colorectal cancer appears worthwhile In this phase III clinical trial conducted by the Gastrointestinal Tract Cancer Cooperative Group of the European Organization for Research and Treatment of Cancer ( GITCCG-EORTC ) , we evaluated the effect of adjuvant intraportal infusion of heparin ( HEP ) and 5-fluorouracil ( 5-FU ) on overall survival , disease-free survival and time to progression in patients with resectable colon cancer . From January 1983 to June 1987 , 235 patients were r and omised from 14 institutions in seven European countries : 79 patients made up the control group ( control ) : 72 the portal vein infusion group given heparin alone ( 5000 IU daily x 7 consecutive days ) ( HEP ) ; 84 the portal vein infusion group given heparin ( 5000 IU daily x 7 consecutive days ) and 5-FU ( 500 mg/m2 daily x 7 consecutive days ) ( HEP/5-FU ) ; 34 patients were considered ineligible . The 199 patients considered eligible were well balanced for age , sex , Karnofsky index , tumour location , surgery , surgical procedure and Dukes ' stage . Four patients ( 2 control , 1 HEP , 1 HEP/5-FU ) died of surgical complications . No differences were observed between control group and treatment groups ( HEP , HEP/5-FU ) for postoperative complications and number of hospitalisation days . Severe toxicity ( grade 3 - 4 , WHO ) was found in 12 % of patients in the HEP group and 8 % in the HEP/5-FU group . After a median follow-up of 9 years , disease progression was reported in 40 % of patients in the control group , 40 % in the HEP group and 29 % in the HEP/5-FU group . Five-year survival , time to progression and disease-free survival were 69 % , 58 % and 56 % , respectively , in the control arm , 61 % , 58 % and 56 % in the HEP arm , and 71 % , 69 % and 65 % in the HEP/5-FU arm . Based on all r and omised patients , the effect of treatment was not statistically significant with respect to any of the endpoints . It is confirmed that intraportal 5-FU infusion is safe and has a tolerable toxicity , but can not be considered st and ard treatment for patients with resectable colon cancer Background and Methods . Fifty‐one patients with small cell lung cancer ( SCLC ) were treated with alternating urokinase (UK)‐cyclophosphamide‐doxorubicin ( Adriamycin , Adria Laboratories , Columbus , OH)‐vincristine and cisplatin‐etoposide‐vincristine . UK was given as a loading dose of 3000 μg/kg body weight , followed by 3000 μg/kg/h for 6 hours . Thoracic irradiation with split technique ( 46 Gy ) and prophylactic cranial irradiation ( 25 Gy ) were administered to responding patients . A second staging was performed in patients exhibiting a clinical complete response ( CR ) after 1 year Background . A positive influence of anticoagulant treatment in small cell lung cancer ( SCLC ) has been sug gested by experimental and clinical data The Cancer and Leukemia Group B ( CALGB ) conducted a prospect i ve r and omized trial to evaluate the role of warfarin and alternating chemotherapy in extensive small-cell lung cancer ( SCCL ) . After stratification for sex and performance status , patients were r and omly assigned to receive chemotherapy with methotrexate , doxorubicin ( Adriamycin ; Adria Laboratories , Columbus , OH ) , cyclophosphamide , and lomustine ( CCNU ) ( MACC ) , or MACC plus warfarin ( MACC + W ) , or mitomycin , etoposide , cisplatin , and hexamethylmelamine alternating with MACC ( MEPH/MACC ) . Warfarin was given continuously to maintain a prothrombin time of one and one half to twice the control values . A total of 328 patients were enrolled , and 294 were evaluable . There was a statistically significant advantage in objective response rates ( complete [ CR ] and partial responses [ PR ] , respectively ) for MACC + W ( 17 % and 50 % ) as compared with MACC alone ( 8 % and 43 % ) or MEPH/MACC ( 10 % and 38 % ) ( P = .012 ) . Both failure-free survival ( P = .054 Wilcoxon test ) and overall survival ( P = .098 Wilcoxon test ) were higher on MACC + W ( median , 6.6 months and 9.3 months , respectively ) , as compared with MACC ( 5.0 months and 7.9 months ) and MEPH/MACC ( 5.0 months and 7.9 months ) . Toxicity was comparable among the three arms , except for increased hemorrhagic events on MACC + W , which were life-threatening in four patients ( 4 % ) , and lethal in two others ( 2 % ) . These data support the role of warfarin in the treatment of SCCL , but do not establish its mechanism of action . Warfarin deserves further studies in SCCL , particularly in patients with limited disease VA Cooperative Study # 75 was established to test in a controlled , r and omized trial the hypothesis that warfarin anticoagulation would favorably affect the course of certain types of malignancy . No differences in survival were observed between  warfarin‐treated  and control groups for advanced non‐small cell lung , colorectal , head and neck and prostate cancers . However , warfarin therapy was associated with a significant prolongation in the time to first evidence of disease progression ( P = 0.016 ) and a significant improvement in survival ( P = 0.018 ) for patients with small cell carcinoma of the lung , including the subgroup of patients with disseminated disease at the time of r and omization ( P = 0.013 ) . A trend toward improved survival  with warfarin treatment was observed for the few patients admitted to this study with non‐small cell lung cancer who had minimal disease at r and omization . These results suggest that warfarin , as a single anticoagulant agent , may favorably modify the course of some , but not all , types of human malignancy , among which is small cell carcinoma of the lung . Further trials of warfarin may be indicated in patients with limited disease who have cell types that failed to respond when advanced disease was present The object of this study was to see if the addition of anticoagulants to a regimen of cytotoxic drugs would improve the prognosis in patients with small cell carcinoma of the bronchus . Twenty-four patients were r and omly allocated to receive chemotherapy or chemotherapy plus anticoagulants . The median survival in the group receiving the anticoagulants was not improved Analysis of data from a r and omised trial of adjuvant razoxane involving 603 patients with colo-rectal cancer having curative surgery is reported . The results show that razoxane was ineffective but peri-operative subcutaneous heparin treatment apparently conferred a statistically significant improvement in survival at 5 years , or equivalently a reduction in the risk of death . This beneficial effect is apparent in both razoxane treated and control patients and is not explained by demonstrable differences between heparin and non-heparin treated patients in the distribution of known prognostic factors . Adjustment for these factors slightly increased the apparent magnitude of the beneficial effect . RésuméL'analyse des résultats d'une étude r and omisée sur le traitement adjuvant par Razoxane et comprenant 603 patients porteurs d'un cancer colo-rectal ayant eu une chirurgie curatrice est reportée . Les résultats montrent que le Razoxane était inefficient mais que le traitement péri-opératoire par Héparine sous cutanée montrait apparemment une amélioration statistiquement significative dans la survie à 5 ans ou de façon équivalente une réduction du risque de mort . Cet effet bénéfique est apparent dans les deux groupes de patients traités par Razoxane et contrôles et n'est pas expliqué par une différence de la distribution des facteurs pronostiques connus entre les patients héparinés ou non héparinés . L'ajustement de ces facteurs augmente légèrement l'ampleur apparente de cet effet bénéfique In this r and omized trial adjuvant cytotoxic portal vein perfusion in patients undergoing surgery for colorectal cancer without liver metastases was assessed to determine whether the incidence of meta‐chronous liver metastases could be reduced and survival thereby improved . There were 127 control patients and 117 patients who received adjuvant perfusion .  A further 13 patients were excluded following r and omization because of cirrhosis in 1 , liver metastases at laparotomy in 3 and technical problems with cannulation in 9 . Dukes ' staging and degree of differentiation were similar in the two groups . There were fewer liver metastases in the perfusion patients and overall survival was improved . However , the benefit appears to be greatest in patients with Dukes ' B colon cancer This prospect ively r and omized clinical trial was carried out in four Dutch hospitals to reduce the development of metachronous liver metastases and to get a better survival in patients with colorectal malignancies after surgically radical en bloc resection of the primary tumor and the regional lymph nodes . Three hundred seventeen patients were r and omized to participate in three trial arms . One group of patients was treated by surgery alone ( control group ) ; in the other patients a catheter was placed in the dilated umbilical vein and advanced until the tip was lying in the left branch of the portal vein . Fifty percent of these patients got immediate postoperative portal infusion with 1 g 5‐fluorouracil ( 5‐FU ) and 5000 U heparin daily for 7 days ; the others received portal vein infusion with urokinase 10,000 U/hour for 24 hours only . Three hundred four patients were eligible . Overall hospital mortality was 3.6 % ( 11 patients ) and was not influenced by adjuvant treatment . After a median follow‐up of 44 months 66 patients have died with relapse and 21 as a result of other causes . The chance of developing liver metastases and other distant metastases after portal infusion with 5‐FU/heparin was one third of the chance in the control group ( P < 0.001 ) . Only an insignificant reduction of the average death rate in the 5‐FU/heparin group was found . In the urokinase group no significant effect in reducing metastases or in survival was noted . Before recommending cytotoxic portal infusion as an adjuvant treatment in patients with colorectal cancer , detailed analysis of other ongoing portal infusion studies has to be awaited and careful calculations have to be made regarding how many patients really can be saved by this treatment Colorectal liver metastases develop by malignant cells entering the portal venous circulation . A r and omized prospect i ve clinical trial was commenced in 1975 to assess the value of adjuvant umbilical vein cytotoxic perfusion ( with 5‐fluorouracil ) following colorectal resection 
    Output:
    
We conclude that there is no convincing evidence of either positively or negatively effects of UFH on survival of patients with malignancy