Heated abdominal chemotherapy is not beneficial

<p class="article-intro">A randomized phase-III-trial shows that people with advanced colorectal cancer may not need a heated chemotherapy delivered to the abdomen during surgery. There was no difference in survival between patients with metastases in the abdomen who received heated chemotherapy during surgery and those who received surgery alone.</p> <hr /> <p class="article-content"><p>The PRODIGE 7 trial enrolled 265 patients in France who had stage IV colorectal cancer with peritoneal carcinomatosis, and no metastases elsewhere in the body. The patients were randomly assigned to receive surgery plus HIPEC (chemotherapy oxaliplatin heated to 43&deg;C in an attempt to increase chemotherapy efficacy) or surgery alone. 96 % of the patients also received systemic chemotherapy, before surgery, after surgery or both. The type of systemic therapy was per physician choice.</p> <p>At a median follow-up of 64 months, the median overall survival was 41,2 months in the non-HIPEC group vs. 41,7 months in the HIPEC group (the difference between the two groups was not statistically significant). The recurrence-free survival was also similar between the two groups: median 11,1 months in the non-HIPEC group vs. median 13,1 months in the HIPEC group. The overall mortality rate at 30 days after surgery was 1,5 % in both groups, and there was no difference in the rate of side effects during the first 30 days. At 60 days, however, the rate of complications in the HIPEC group was almost double that in the non-HIPEC group (24,1 % vs. 13,6 % ).</p> <p>More research is needed to determine if there are patients who would still benefit from receiving HIPEC with surgery. A subgroup analysis from this study suggests that HIPEC might be beneficial for patients with a mid-range peritoneal cancer index, but the numbers were too small to be conclusive. People with a low peritoneal cancer index can likely forgo HIPEC, whereas those with a high index may not benefit from either surgery or HIPEC. Meanwhile, other types of chemotherapy may be more effective than oxaliplatin, the type of chemotherapy used in HIPEC for this study.</p> <p><strong>Reference:</strong> <br />Quenet F et al.: A UNICANCER phase III trial of hyperthermic intra-peritoneal chemotherapy (HIPEC) for colorectal peritoneal carcinomatosis (PC): PRODIGE 7. ASCO Annual Meeting 2018, abstract #LBA3503</p></p>