Locally advanced colon cancer refers to tumors localized to adjacent organs in patients without distant metastases. Around a quarter of patients with locally advanced colon cancer are likely to develop peritoneal metastases, a condition without curative options. This study aims to investigate the efficacy of adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with locally advanced colon cancer.
This open-label, multicenter trial included a total of 202 patients with clinical or pathological T4N0–2M0-stage tumors or perforated colon cancer. The patients were randomly assigned in a 1:1 ratio to adjuvant HIPEC followed by routine adjuvant systemic chemotherapy (n=100) or to adjuvant systemic chemotherapy only (n=102) (control). The primary outcome of the study was peritoneal metastasis free-survival at 18 months.
In the HIPEC group, 19 patients (19%) developed peritoneal metastases, as compared with 23 (23%) in the control group. The intention-to-treat analysis exhibited no significant difference in peritoneal-free survival at 18-months between the two groups (80.9% for HIPEC and 76.2% for control). Fourteen percent of patients who received adjuvant HIPEC developed postoperative complications.
The research concluded that in patients with locally advanced colon cancer, treatment with adjuvant HIPEC was not associated with an improved peritoneal metastasis-free survival at 18 months when compared with adjuvant systemic chemotherapy only.