Oncology · Surgery ·
Matched analysis finds similar outcomes with CRS alone or mitomycin C HIPEC
An author reflection in Annals of Surgical Oncology discusses a single-center propensity score-matched analysis of cytoreductive surgery (CRS) for colorectal peritoneal metastases. Recurrence outcomes were comparable with and without HIPEC, while HIPEC was associated with more severe postoperative complications and longer hospital stays.
- Matched recurrence outcomes were comparable between treatment groups.
- HIPEC was associated with more severe postoperative adverse events.
- The analysis was observational and single-center.
- A node-negative subgroup finding was exploratory.
The reflection summarizes an institutional study of 107 patients who underwent curative-intent CRS for colorectal cancer peritoneal metastases; 39 received CRS alone between 2021 and 2024. After propensity score matching on established prognostic factors, the investigators compared a 1:2 cohort receiving CRS alone or CRS with HIPEC. Outcomes included recurrence-free survival (RFS), peritoneal recurrence-free survival (p-RFS), and postoperative outcomes through 90 days.
In the matched cohort, RFS and p-RFS were comparable between groups. Patients who received HIPEC had more grade III or higher postoperative adverse events and longer hospital stays. An exploratory subgroup analysis suggested a possible RFS benefit from HIPEC among patients with node-negative primary tumors, but the authors note the small sample size.
The authors argue that these findings challenge routine mitomycin C HIPEC after CRS and support evaluating the approach in randomized trials; the ongoing GECOP-MMC trial is noted. The evidence described here is from a single-center, propensity-matched observational analysis, not a randomized comparison, and no effect estimates are provided in the reflection. The findings do not establish that HIPEC should be discontinued for all patients.
In practice
For patients with resectable colorectal peritoneal metastases undergoing curative-intent cytoreductive surgery, this single-center propensity-matched analysis found comparable recurrence-free and peritoneal recurrence-free survival with CRS alone versus CRS plus HIPEC, alongside more severe postoperative adverse events and longer hospitalization in the HIPEC group. These observational findings do not establish equivalence or prove that HIPEC should be omitted in practice. The possible benefit in patients with node-negative primary tumors was exploratory and limited by small numbers; randomized evidence is needed.
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Annals of Surgical Oncology: ASO Author Reflections: Futility of Mitomycin C HIPEC in Colorectal Peritoneal Metastases-Time for a Change ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.