Some patients with advanced colorectal cancer develop metastases in the lining of the abdominal cavity, known as peritoneal metastases. Cytoreductive surgery (CRS) can help remove most tumors, and it is sometimes combined with heated chemotherapy delivered to the abdominal cavity – a treatment approach called hyperthermic intraperitoneal chemotherapy (HIPEC) – to eliminate remaining cancer cells.
In a retrospective study, researchers led by Michael White, M.D., and Paula Smith, M.D., examined the benefits of HIPEC in 147 patients with colorectal cancer and peritoneal metastases who received CRS from 2008 to 2023. They compared overall survival (OS) and peritoneal disease-free survival (PDFS) in patients treated with CRS alone or with HIPEC. The researchers also studied each patient’s peritoneal cancer index (PCI), a scoring system to assess the extent of cancer spread. Researchers found that patients with PCI of 11 or higher had significantly improved OS with CRS-HIPEC compared to those who received CRS alone. Conversely, patients with lower PCI scores did not have any added benefit. These findings suggest adding HIPEC to surgery when treating peritoneal metastases benefits certain patients with colorectal cancer, allowing doctors to forgo HIPEC for others.