Adjuvant hyperthermic intraperitoneal chemotherapy in patients with colon cancer at high risk of peritoneal metastases: individual patient data meta-analysis - Report - MDSpire

Adjuvant hyperthermic intraperitoneal chemotherapy in patients with colon cancer at high risk of peritoneal metastases: individual patient data meta-analysis

  • By

  • Julie J M Hamm

  • Rudolf van den Berg

  • Eleni-Rosalina Andrinopoulou

  • E Sophie Zwanenburg

  • Gijsbert D Musters

  • Pieter J Tanis

  • Alvaro Arjona-Sanchez

  • the COLOPEC and HIPECT4 Collaborator Groups

  • E S Zwanenburg

  • C E L Klaver

  • D D Wisselink

  • C J A Punt

  • P Snaebjornsson

  • J Crezee

  • A G J Aalbers

  • A R M Brandt-Kerkhof

  • A J A Bremers

  • J W A Burger

  • H F J Fabry

  • F T J Ferenschild

  • S Festen

  • W M U van Grevenstein

  • P H J Hemmer

  • I H J T de Hingh

  • N F M Kok

  • M Kusters

  • L Schoonderwoerd

  • J B Tuynman

  • A W H van de Ven

  • H L van Westreenen

  • M J Wiezer

  • D D E Zimmerman

  • A van Zweeden

  • M G W Dijkgraaf

  • G D Musters

  • M Ortega-Salas Rosa

  • A Martínez-López

  • E M Torres-Tordera

  • B Rufian-Andujar

  • F Valenzuela-Molina

  • A Gordon-Suarez

  • F J Medina-Fernandez

  • A Gomez-España

  • F Triviño-Tarradas

  • M Granados-Rodríguez

  • M C Vazquez-Borrego

  • M Garzas-Martin Almagro

  • I Inmaculada Lasa-Unzué

  • R Gómez-Sanz

  • A López-García

  • M Díez-Alonso

  • P Hernández-Juara

  • R Molina-Villaverde

  • C Castillo Torres

  • J I Busteros Moraza

  • J J Segura-Sampedro

  • R Rafael Morales-Soriano

  • C Pineño-Flores

  • A Serrano Del Moral

  • I Manzanedo

  • F Pereira

  • M E Moneva Arce

  • R Gianchandani-Moorjani

  • J M Sánchez-González

  • C Díaz-López

  • G Hernandez Hernandez

  • J G Diaz Mejias

  • M J Hernández Barroso

  • R M Abreu-Falcon

  • A Muñoz Hernández

  • V Castro López Taruella

  • C Hernandez Pérez

  • R Afonso

  • M Viña-Romero

  • R Perez-Rodriguez

  • M Heras-Garceau

  • I Ramos

  • O Crusellas Maña

  • M A Lorenzo Liñán

  • P A Parra Baños

  • M Carrasco Prats

  • M Ruiz Marín

  • E Terol Garaulet

  • F García Molina

  • I M Gallarín Salamanca

  • M González Cordero

  • A Titos García

  • S González-Moreno

  • A Mayol Oltra

  • April 29, 2025

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Efficacy of Adjuvant HIPEC in High-Risk Locally Advanced Colon Cancer

Overview

This individual patient data meta-analysis pooled data from two randomized controlled trials including 386 patients to assess the efficacy of adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) in reducing locoregional recurrence in locally advanced colon cancer. While HIPEC did not significantly reduce recurrence in the overall population, a significant benefit was observed in patients with right-sided tumors.

Background

Colorectal cancer is a leading cause of cancer mortality worldwide, with peritoneal metastases being a common and poor prognostic site of recurrence. Patients with locally advanced (pT4) colon cancer are at increased risk of locoregional recurrence, including peritoneal metastases, which are often resistant to systemic chemotherapy. Adjuvant HIPEC, delivering heated chemotherapy directly into the peritoneal cavity during surgery, has been proposed to reduce peritoneal recurrence. However, evidence from randomized trials has been limited and subgroup effects remain unclear.

Data Highlights

ParameterHIPEC Group (n=189)Control Group (n=197)
Median follow-up (months)36 (IQR 32–60)
36-month locoregional recurrence rate16.0%21.2%
Hazard ratio for locoregional recurrence in right-sided tumors0.56 (95% CI 0.48 to 0.67), P < 0.001

Key Findings

  • Adjuvant HIPEC did not significantly reduce locoregional recurrence in the overall population of locally advanced colon cancer patients (P = 0.295).
  • In patients with right-sided colon tumors, HIPEC significantly reduced locoregional recurrence (HR 0.56, 95% CI 0.48 to 0.67; P < 0.001).
  • No significant differences in disease-free survival or overall survival were observed in the overall population, likely due to low event rates and limited follow-up.
  • The meta-analysis included data from two RCTs (COLOPEC and HIPECT4) with a total of 386 patients.
  • Adjuvant systemic chemotherapy alone may be insufficient to prevent peritoneal metastases in high-risk patients due to relative resistance of peritoneal disease.

Clinical Implications

Adjuvant HIPEC should be considered as a therapeutic option to reduce locoregional recurrence in patients with right-sided locally advanced colon cancer. However, its benefit in left-sided tumors remains unproven. Longer follow-up and further research are needed to clarify effects on survival outcomes and to optimize patient selection for this intervention.

Conclusion

Adjuvant HIPEC significantly reduces locoregional recurrence in right-sided locally advanced colon cancer but not in the overall population. Definitive conclusions on survival benefits require extended follow-up and additional studies.

References

  1. COLOPEC and HIPECT4 Trials -- Adjuvant HIPEC in Locally Advanced Colon Cancer

Original Source(s)

Adjuvant hyperthermic intraperitoneal chemotherapy in patients with colon cancer at high risk of peritoneal metastases: individual patient data meta-analysis

  • by Julie J M Hamm, Rudolf van den Berg, Eleni-Rosalina Andrinopoulou, E Sophie Zwanenburg, Gijsbert D Musters, Pieter J Tanis, Alvaro Arjona-Sanchez, the COLOPEC and HIPECT4 Collaborator Groups, E S Zwanenburg, C E L Klaver, D D Wisselink, C J A Punt, P Snaebjornsson, J Crezee, A G J Aalbers, A R M Brandt-Kerkhof, A J A Bremers, J W A Burger, H F J Fabry, F T J Ferenschild, S Festen, W M U van Grevenstein, P H J Hemmer, I H J T de Hingh, N F M Kok, M Kusters, L Schoonderwoerd, J B Tuynman, A W H van de Ven, H L van Westreenen, M J Wiezer, D D E Zimmerman, A van Zweeden, M G W Dijkgraaf, G D Musters, M Ortega-Salas Rosa, A Martínez-López, E M Torres-Tordera, B Rufian-Andujar, F Valenzuela-Molina, A Gordon-Suarez, F J Medina-Fernandez, A Gomez-España, F Triviño-Tarradas, M Granados-Rodríguez, M C Vazquez-Borrego, M Garzas-Martin Almagro, I Inmaculada Lasa-Unzué, R Gómez-Sanz, A López-García, M Díez-Alonso, P Hernández-Juara, R Molina-Villaverde, C Castillo Torres, J I Busteros Moraza, J J Segura-Sampedro, R Rafael Morales-Soriano, C Pineño-Flores, A Serrano Del Moral, I Manzanedo, F Pereira, M E Moneva Arce, R Gianchandani-Moorjani, J M Sánchez-González, C Díaz-López, G Hernandez Hernandez, J G Diaz Mejias, M J Hernández Barroso, R M Abreu-Falcon, A Muñoz Hernández, V Castro López Taruella, C Hernandez Pérez, R Afonso, M Viña-Romero, R Perez-Rodriguez, M Heras-Garceau, I Ramos, O Crusellas Maña, M A Lorenzo Liñán, P A Parra Baños, M Carrasco Prats, M Ruiz Marín, E Terol Garaulet, F García Molina, I M Gallarín Salamanca, M González Cordero, A Titos García, S González-Moreno, A Mayol Oltra

  • April 29, 2025

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