HIPEC offers no benefit for CRC peritoneal metastasis

  • Lancet Oncol

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Adding hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreductive surgery does not lead to improved OS and is tied to more postoperative late complications in colorectal peritoneal metastases.

Why this matters

  • The longer-than-expected survival with surgery alone suggests that completeness of cytoreductive surgery is the best predictor of survival.

Study design

  • Randomized, multicenter, open-label, phase 3 trial (PRODIGE 7; N=265).
  • Funding: Institut National du Cancer; Programme Hospitalier de Recherche Clinique du Cancer; Ligue Contre le Cancer.

Key results

  • Median follow-up, 63.8 months.
  • Median OS:
    • 41.7 months with cytoreductive surgery only vs 41.2 months with surgery+HIPEC group (HR, 1.00; P=.99).
  • Median OS rates, surgery vs surgery+HIPEC:
    • 1 year: 88.3% vs 86.9%.
    • 5 year: 36.7% vs 39.4%.
  • Each group had 2 treatment-related deaths at 30 days.
  • Grade ≥3 adverse events were not statistically significantly different between the HIPEC+surgery and surgery-only groups at 30 days (42% vs 32%; P=.083), but the frequency was significantly higher in the HIPEC group at 60 days (26% vs 15%: P=.035).

Limitations

  • Potential selection bias related to included patients.