Preliminary results with the use of hyperthermic intraperitoneal intraoperative chemotherapy or systemic chemotherapy in high-risk colorectal cancer patients

Background: Patients with locally advanced colorectal carcinomas are at high risk to develop metastatic disease even after R 0 resection. The purpose of the study is to compare the effects of hyperthermic intraperitoneal intraoperative chemotherapy (HIPEC) and systemic chemotherapy in patients with locally advanced colorectal carcinomas. The end point of the study is the analysis of survival and recurrences. Methods: Patients with locally advanced colorectal carcinomas (T 3 , T 4 ) that underwent R0 resection were prospectively assigned to receive either HIPEC (HIPEC group) or systemic chemotherapy (Conventional group). Results: The HIPEC group (41 patients) was comparable to Conventional group (40 patients) for gender, ASA-class, performance status, hospital mortality, tumor depth, nodal infiltration, degree of differentiation, anatomic distribution, morbidity, age, and follow-up time (P>0.05). They were different for presence of distant metastases, stage, and recurrences (P 0.05). Two patients in the HIPEC group and 8 patients in the Conventional group were recorded with recurrence (P=0.002). Conclusions: HIPEC as an adjuvant in high risk patients with colorectal cancer appears to be effective in the control of metastases and particularly of the local-regional ones. Further studies are required to document these results.