HIPEC combined with surgery is effective in colorectal cancer with peritoneal metastasis

This study investigated the effectiveness of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer patients with early stage peritoneal metastasis (PM; when the cancer spreads to the abdominal lining). Researchers suggested that HIPEC may benefit these patients.

The peritoneal region is the second most common site for metastasis in colorectal cancer. These patients have a significantly lower survival even when treated with some modern therapies. However, survival improvements have been reported with abdomen surgery combined with HIPEC treatment. HIPEC is a highly concentrated chemotherapy that is delivered directly to the abdomen during surgery. The effectiveness of HIPEC in patients with very early PM is not yet clear.  

The objective of this study was to investigate the effectiveness of surgery combined with HIPEC treatment in colorectal cancer patients with early peritoneal metastasis.

This study included 22 patients that underwent abdomen surgery and HIPEC and 44 patients who underwent surgery alone. Average follow-up for the HIPEC group was 65.2 months and 34.5 months in the surgery alone group.

The 5-year PM incidence was 9.3% in the HIPEC group and 42.5% in the surgery alone group. The 5-year overall survival (time from treatment until death from any cause) was 81.3% in the HIPEC group and 70% in the control group. Moderate side effects were reported for the HIPEC group (18.2% of patients) and in the surgery alone group (25% of patients).

The patients in the HIPEC group had 96% less PM, had 75% improvement in the odds of a better overall survival and a 69% improvement in the odds of a better progression-free survival (time from treatment to disease progression).  

This study reported that colorectal cancer patients with early PM would significantly benefit from abdomen surgery combined with HIPEC treatment. 

This study included a limited number of patients. Larger studies are needed.