Abstract

The final results of three large randomized trials that have recently addressed the role of Hyper thermic Intraperitoneal Chemotherapy (HIPEC) in the management of colorectal cancer peritoneal metastases (CRC-PM) are presented and critically appraised. Prodige-7 trial randomized patients with established CRC-PM after optimal cytoreductive surgery (residual tumor <1mm) to no HIPEC vs. oxaliplatin-based HIPEC. COLOPEC randomly assigned patients who had curative-intent surgery for pT4a/b or perforated CRC to oxaliplatin-based HIPEC given either at primary resection, or staged 5-8 weeks later, and followed by adjuvant systemic chemotherapy (s-CT), vs. standard adjuvant s-CT only. ProphyloCHIP trial randomized HIPEC combined with second-look surgery after adjuvant s-CT vs. standard surveillance in high-risk patients, defined as history of peritoneal or ovarian metastases or perforated primary CRC.