Distribution of 5-fluorouracil to body tissues compared after intraluminal, intravenous, and intramural administration in gastrointestinal cancer.

The distribution of 5-fluorouracil (5-FU) to various potential metastatic sites has been investigated in stomach and colorectal cancer patients, using intraluminal, intravenous, and intramural routes of administration at the time of surgery. The best overall concentrations of 5-FU in systemic blood, portal blood, liver, draining lymph nodes, tumor, and locally in the bowel wall was obtained after intramural injection. The intraluminal route of administration resulted in poor overall distribution of 5-FU. Intravenous administration tended to give levels between those obtained from intramural and intraluminal routes. There was no complication of 5-FU therapy. On the basis of this study we conclude that the intramural route is the most satisfactory for adjuvant administration of 5-FU with surgery. This might be expected to give better results than those obtained in clinical studies using intraluminal and intravenous routes. A controlled trial of 5-FU using the intramural route is indicated in gastric and colorectal cancer to demonstrate whether or not clinical benefit can be obtained.