Abstract
BackgroundThe objective of this study was to investigate the safety and long-term clinical effect of intraperitoneal implantation of sustained-release 5-fluorouracil in patients with advanced colorectal cancer during radical resection.MethodsA total of 202 patients with advanced colorectal cancer undergoing radical operations were randomly divided into an experimental group (98 cases, intraoperative intraperitoneal implantation of sustained-release 5-fluorouracil 600 mg as local chemotherapy) and a control group (104 cases, without local chemotherapy). The clinical data of the two groups was compared including toxicity, complications, local recurrence rate, distant metastasis, disease-free survival, and 1-, 3-, and 5-year survival rates.ResultsBoth groups of patients were followed up for more than 5 years, the longest follow-up time was 7.5 years. Bone marrow suppression, hepato-renal function, postoperative anastomotic leakage, pelvic effusion, incision infection, the incidence of intestinal obstruction, venting time, and hospital stay after operation (days) between two groups had no statistical significant difference. Locoregional recurrence and liver metastasis rate were decreased significantly in experimental group (P = 0.04 and 0.04). Extensive peritoneal metastasis and other organ metastasis rates had no significant difference between two groups. In the experimental group, 1-, 3-, and 5-year survival rates were higher than in the control group (95.92 vs 87.50 %, 77.55 vs 64.42 %, and 56.12 vs 40.38 %), which had significant difference. Disease-free survival (DFS) of the experimental group was higher than that of the control group (χ2 = 5.00, P = 0.025).ConclusionsIntraperitoneal implantation of sustained-release 5-fluorouracil is safe for advanced colorectal cancer during radical resection, which can reduce locoregional recurrence rate and liver metastasis rate. The long-term efficacy was reliable, and long-term survival and disease-free survival rate can be improved.
Highlights
The objective of this study was to investigate the safety and long-term clinical effect of intraperitoneal implantation of sustained-release 5-fluorouracil in patients with advanced colorectal cancer during radical resection
In this research, sustained-release 5-Fu was implantated in the peritoneum and para-aortic abdominalis; the results indicated that intraperitoneal implantation of sustained-release 5-Fu is safe for advanced colorectal cancer (CRC) and long-term survival and disease-free survival rate can be improved
No significant difference was found in age, sex, pathological type, clinical stages, and operation method between the two groups (P > 0.05)
Summary
The objective of this study was to investigate the safety and long-term clinical effect of intraperitoneal implantation of sustained-release 5-fluorouracil in patients with advanced colorectal cancer during radical resection. The incidence of colorectal cancer (CRC) tops the list among malignant tumors, and its mortality is very high. The incidence of CRC in China is lower than in the Western world, but has been increasing in recent years [2]. Yuan et al World Journal of Surgical Oncology (2015) 13:320 chemotherapeutic agents to eliminate the cancer cells can prevent tumor recurrence. Several agents used in intraperitoneal chemotherapy include cisplatin, 5-FU, hydroxycamptothecin, and slow-release Sinofuan [3,4,5,6]. 5-fluorouracil (5-Fu) is the most common and effective chemotherapy drug used to treat CRC. Characterized by long action duration, reaching the maximum drug concentration in targeted lesions, reducing the systemic toxicity, and absorption not through gastrointestinal tract, sustained-release 5-Fu can reduce the drug loss and maximize drug utilization
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