Applications of electrochemotherapy in colorectal cancer: systematic review and new perspectives in patients undergoing a curative-intent treatment.

Background Colorectal cancer is one of the most frequently diagnosed malignancies worldwide. Its standard therapies such as radiotherapy, chemotherapy and surgery can lead to systemic impairment and complications. We carried out a systematic literature review in order to figure out the therapeutic role of endoscopic electrochemotherapy among the new emerging treatments available today. Methods A systematic literature search of Ovid, Scopus and Web of Science databases was performed to identify eligible studies. Studies on patients with primary colorectal cancer undergoing ECT were included. 2 Results Eleven studies documented the application of ECT in patients affected by colorectal cancer. Data reported were various and heterogeneous because of the different cancer staging, different intent of the technique and different way to measure the outcomes. However, the studies did not report sufficient data to perform a meta-analysis. Conclusion Although the small number of studies and patients involved, as well as the absence of available data on case-control studies, the application of electrochemotherapy as a minimally invasive therapy for patients suffering from colorectal cancer seems promising. With these assumptions, we will develop a study protocol aimed at highlighting the macroscopic and histological effects of electrochemotherapy in patients with colorectal cancer awaiting surgical treatment.