Stopping Cancer Before It Spreads: A New Approach After Colon Cancer Surgery

Al Mahrizi, A.D., Mossolem, F., Major, E. et al. Prophylactic Intraperitoneal Chemotherapy with Platinum Agents Following Curative Resection for Colorectal Cancer: A Systematic Review and Meta-Analysis. Ann Surg Oncol 33, 2972–2984 (2026). https://doi.org/10.1245/s10434-025-18903-4

What is this study about?

This research looked at a strategy to help prevent colorectal (colon and rectal) cancer from coming back after surgery.

Even when surgery successfully removes all visible cancer, there is still a risk that cancer cells left behind in the abdomen can grow later. This is called peritoneal recurrence, and it can be difficult to treat.

Researchers studied whether giving chemotherapy directly into the abdomen—right around the time of surgery—could help lower this risk.

Illustraction of Colon and Rectum

What is this treatment?

The approach is called prophylactic intraperitoneal chemotherapy (PIC):

• “Prophylactic” means it is given to prevent cancer from coming back

• “Intraperitoneal” means the chemotherapy is delivered directly into the abdominal cavity

• The drugs used are often platinum-based chemotherapy agents, which are commonly used in cancer treatment

This method targets areas where cancer is most likely to return.

Why does this matter?

After colon cancer surgery, standard (IV) chemotherapy may not always reach tiny cancer cells in the abdomen.

This approach aims to:

• Treat cancer cells at the source

• Reduce the chance of recurrence in the abdomen

• Improve how long patients stay cancer-free

What did the researchers do?

The study combined results from multiple prior studies (a systematic review and meta-analysis) involving over 1,200 patients.

Researchers compared:

• Surgery alone or standard treatment

  vs.

• Surgery plus intraperitoneal chemotherapy

What were the results?

• Patients who received this treatment had better disease-free survival—meaning they stayed cancer-free longer

• There were signs it may improve overall survival, but more research is needed

• Importantly, the treatment did not significantly increase serious side effects or complications 

What does this mean for patients?

This research suggests that:

• Delivering chemotherapy directly into the abdomen may help prevent cancer from returning after surgery

• It appears to be safe and well-tolerated in many patients

• It is not yet standard for everyone—more studies are needed to confirm who benefits most

Key takeaways

• Recurrence in the abdomen is a major challenge after colorectal cancer surgery

• This targeted chemotherapy approach is a promising way to reduce that risk

• Ongoing research will help determine how and when to use it best

Questions patients may want to ask their care team

• Am I at risk for cancer coming back in the abdomen?

• Are there treatments to help prevent recurrence after surgery?

• Is intraperitoneal chemotherapy an option for me?

• Are there clinical trials I should consider?

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