- 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.
- 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.
- 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).
- Potential selection bias related to included patients.