The following is a summary of “Adjuvant Hyperthermic Intraperitoneal Chemotherapy in Patients With Locally Advanced Colon Cancer (COLOPEC): 5-Year Results of a Randomized Multicenter Trial,” published in the November 2023 issue of Oncology by Zwanenburg, et al.
For a study, researchers sought to assess the 5-year oncologic outcomes of patients enrolled in the randomized multicenter COLOPEC trial, focusing on the potential benefits of adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) in preventing peritoneal metastases after curative surgery for high-risk colon cancer.
The COLOPEC trial encompassed patients diagnosed with either clinical or pathologic T4N0-2M0 stage or those with perforated colon cancer. These patients were randomly allocated in a 1:1 ratio to receive adjuvant systemic chemotherapy combined with HIPEC (n = 100) or adjuvant systemic chemotherapy alone (n = 102). The HIPEC procedure involved a single administration of oxaliplatin (460 mg/m2) for 30 minutes at 42°C, concurrently with fluorouracil/leucovorin intravenously. This administration was performed simultaneously (9% of cases) or within 5-8 weeks (91% of cases) following the primary tumor resection. Outcomes were analyzed following the intention-to-treat principle. The study reported long-term data from all 202 participants, with a median follow-up period of 59 months (IQR, 54.5-64.5).
The analysis revealed no significant disparity in the 5-year overall survival rate between the two groups: those receiving adjuvant HIPEC followed by systemic chemotherapy versus those receiving only adjuvant systemic chemotherapy (69.6% vs. 70.9%; P = .692). Additionally, the 5-year rates of peritoneal metastases were comparable between the groups at 63.9% and 63.2%, respectively (P = .907). Similarly, the 5-year disease-free survival rates were 55.7% and 52.3%, respectively (P = .875). Quality-of-life outcomes did not show any discernible differences between the two groups.
Based on the findings, the study suggested that incorporating adjuvant HIPEC in the treatment regimen for high-risk colon cancer should be reserved for trial settings only, as it did not offer substantial benefits in long-term oncologic outcomes.
Source: ascopubs.org/doi/10.1200/JCO.22.02644
