Effectiveness and safety of intraoperative intraperitoneal 5-Fu drug implantation in patients with colorectal cancer: a retrospective cohort study

J Cancer Res Clin Oncol. 2024 Feb 13;150(2):92. doi: 10.1007/s00432-023-05523-2.

Abstract

Purpose: The purpose of this clinical study was to evaluate the efficacy and safety of intraoperative chemotherapy (IOC) with intraoperative intraperitoneal implantation of 5-fluorouracil (5-FU) in colorectal cancer (CRC) patients.

Methods: In this study, 165 patients who underwent colorectal radical surgery were selected, of whom 111 in the experimental group received surgical treatment with an intraperitoneal 5-fluorouracil (5-FU) implantation. Fifty-four patients who did not undergo intraperitoneal implantation of 5-FU were matched to compare the progression-free survival (PFS) and overall survival (OS) with the former.

Results: We also studied the differences in the changes of different biochemical indicators between the two groups before and after surgery, and there were significant differences in leukocytes, neutrophils, and lymphocytes before and after (P < 0.05), while for sodium ions, potassium ions, platelets, alanine transaminase, aspartate transaminase, creatinine, urea, and albumin, there were no significant differences. This may be related to the intraperitoneal chemotherapy implant entering the blood circulation. For 5-year OS, there were 85/111 (76.58%) in the 5-FU group (P = 0.013) and 35/54 (64.81%) in the control group; for 5-year PFS, there were 84/111 (75.68%) in the 5-FU group and 29/54 (53.70%) in the control group (P = 0.02). All the experimental groups were better than the control group with a significant difference in the experimental results.

Conclusion: For CRC surgery patients, intraperitoneal implantation of slow-release 5-FU drugs, which is a safe and simple procedure, can improve the prognosis of the patients.

Clinical trial registration: No clinical trials were performed in the study.

Keywords: Colorectal cancer; Long-term effect; Postoperative chemotherapy; Safety; Sustained-release 5-fluorouracil.

MeSH terms

  • Albumins*
  • Colorectal Neoplasms* / drug therapy
  • Colorectal Neoplasms* / surgery
  • Fluorouracil / adverse effects
  • Humans
  • Ions
  • Retrospective Studies

Substances

  • Albumins
  • Fluorouracil
  • Ions