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After thirty years of experience with early postoperative intraperitoneal 5-fluorouracil now saying goodbye. [Review]

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Citation: Surgical Oncology. 42:101757, 2022 Jun.PMID: 35398760Institution: Washington Cancer InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Colorectal Neoplasms | *Hyperthermia, Induced | *Peritoneal Neoplasms | Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use] | Colorectal Neoplasms/dt [Drug Therapy] | Colorectal Neoplasms/pa [Pathology] | Combined Modality Therapy | Cytoreduction Surgical Procedures | Fluorouracil | Humans | Mitomycin/tu [Therapeutic Use] | Peritoneal Neoplasms/dt [Drug Therapy] | Peritoneal Neoplasms/sc [Secondary]Year: 2022 ISSN:

0960-7404

Name of journal: Surgical oncologyAbstract: In the management of colorectal and appendiceal peritoneal metastases, intraperitoneal 5-fluorouracil (5-FU) has been used in 3 different ways. It has been used as part of an early postoperative intraperitoneal chemotherapy (EPIC) regimen along with EPIC mitomycin C. This EPIC mitomycin C plus EPIC 5-FU has been shown to be equivalent or inferior to HIPEC. Because it is more work intensive than HIPEC and not superior, its use should be abandoned if HIPEC is available. A second way to use intraperitoneal 5-FU is along with HIPEC. Several studies suggest a survival advantage for the combination of HIPEC with EPIC 5-FU. However, patient ineligibility for EPIC 5-FU in high-risk CRS is more likely the cause for the alleged survival advantage attributed to the combination. A third use of intraperitoneal 5-FU is long-term through a peritoneal access device. This plan for 5-FU use has shown favorable results in three randomized controlled studies. Normothermic intraperitoneal chemotherapy (NIPEC) with 5-FU should be considered as a regional chemotherapy component of a randomized trial for prevention or treatment of peritoneal metastases from colorectal or appendiceal cancer. Intravenous oxaliplatin combined with NIPEC 5-FU has been suggested as a bidirectional adjuvant regimen. Copyright © 2022 Elsevier Ltd. All rights reserved.All authors: Sugarbaker PHFiscal year: FY2022 Digital Object Identifier:

https://dx.doi.org/10.1016/j.suronc.2022.101757

Date added to catalog: 2022-12-13

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Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	35398760	Available		35398760

In the management of colorectal and appendiceal peritoneal metastases, intraperitoneal 5-fluorouracil (5-FU) has been used in 3 different ways. It has been used as part of an early postoperative intraperitoneal chemotherapy (EPIC) regimen along with EPIC mitomycin C. This EPIC mitomycin C plus EPIC 5-FU has been shown to be equivalent or inferior to HIPEC. Because it is more work intensive than HIPEC and not superior, its use should be abandoned if HIPEC is available. A second way to use intraperitoneal 5-FU is along with HIPEC. Several studies suggest a survival advantage for the combination of HIPEC with EPIC 5-FU. However, patient ineligibility for EPIC 5-FU in high-risk CRS is more likely the cause for the alleged survival advantage attributed to the combination. A third use of intraperitoneal 5-FU is long-term through a peritoneal access device. This plan for 5-FU use has shown favorable results in three randomized controlled studies. Normothermic intraperitoneal chemotherapy (NIPEC) with 5-FU should be considered as a regional chemotherapy component of a randomized trial for prevention or treatment of peritoneal metastases from colorectal or appendiceal cancer. Intravenous oxaliplatin combined with NIPEC 5-FU has been suggested as a bidirectional adjuvant regimen. Copyright © 2022 Elsevier Ltd. All rights reserved.

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