Colorectal cancer: speculations on the role of intraperitoneal therapy

Treatment of colorectal cancer beyond surgical resection has had only minimal success in the past. Studies are therefore examining the most advantageous use of currently available treatment methods. Most experience with colorectal cancer has involved 5-fluorouracil; alternatives for adjuvant therapy include combination therapy, immunotherapy, and locoregional therapy. Some success has also been reported with portal vein infusion or intraperitoneal administration of chemotherapeutic agents. Comparison of recurrence data indicates that approximately one third of patients with extrapelvic colorectal cancer can be expected to have peritoneal seeding. Many factors, including selection of patients and chemotherapeutic agents, method of administration, devices used, and techniques for monitoring patients affect the results of any clinical study. Future directions for the adjuvant treatment of colorectal cancer might involve the addition of other agents to the intraperitoneal regimen or of whole abdominal or liver radiation, and also concomitant systemic or portal vein 5-fluorouracil.