ArticleJournal of the American College of Surgeons2025
Long-Term Cytoreduction Outcomes With or Without Heated Intraperitoneal Chemotherapy For Colorectal Peritoneal Metastases.
Article in Journal of the American College of Surgeons, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Repeat Cytoreductive Surgery for Colorectal Cancer Metastatic to the Peritoneal Cavity.Annals of surgical oncology · 2026Article
- Impact of Omission of Hyperthermic Intraperitoneal Chemotherapy for Treatment of Colorectal Peritoneal Metastases.The Permanente journal · 2026Article
- Article
- ASO Author Reflections: Role of Repeat Cytoreductive Surgery for Patients with Recurrent Colorectal-Cancer-Related Peritoneal Metastases.Annals of surgical oncology · 2025Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundPatients with peritoneal metastases from colorectal adenocarcinoma (CRC) benefit from cytoreductive surgery (CRS). However, the role of heated intraperitoneal chemotherapy (HIPEC) remains unclear. We studied associations between HIPEC, peritoneal disease-free survival (PDFS), and overall survival (OS) in patients with CRC undergoing CRS. STUDY
designAll patients with CRC undergoing CRS between 2008 and 2023 were retrospectively identified at our center. Patient clinicodemographic factors were determined by chart review. OS and PDFS were evaluated using the Kaplan-Meier method. Associations between clinical factors and survival were determined using Cox proportional hazard models.
resultsA total of 147 patients were identified with 24.5-month median follow-up. Most patients (111; 75.5%) had a low peritoneal cancer index (PCI; less than 11), whereas 36 patients (24.5%) had high PCI (11 or more). Eighty-three patients (55.8%) had CRS alone. Sixty-four patients underwent CRS with HIPEC (42 [66%] mitomycin C [MMC], 19 [30%] oxaliplatin [OX], 3 [4.7%] cisplatin). The median OS was 59.8 (95% CI 41.7 to 83.0) months. The median PDFS was 13.3 (95% CI 10.4 to 18.5) months. OS was equivalent comparing HIPEC with MMC, HIPEC with OX (hazard ratio [HR] 0.49, 95% CI 0.22 to 1.09, p = 0.08), and CRS alone (HR 0.74, 95% CI 0.41 to 1.32, p = 0.31). Multivariable analysis showed only PCI was associated with OS (HR 1.08, 95% CI 1.03 to 1.14, p = 0.003). Low PCI patients had similar PDFS after CRS-HIPEC (HR 1.07, 95% CI 0.61 to 1.87, p = 0.814) compared with CRS alone. High PCI patients had improved OS comparing CRS-HIPEC with CRS (MMC: HR 0.17, 95% CI 0.04 to 0.76, p = 0.02; OX: HR 0.048, 95% CI 0.006 to 0.37, p = 0.004).
conclusionsHIPEC was not associated with OS or PDFS in patients with PCI 10 or less but was associated with improved OS and PDFS in patients with PCI 11 or more. The use of HIPEC for high PCI may be warranted, although randomized prospective data are needed to confirm this.
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