Doctors have long used a special heated chemotherapy treatment called HIPEC along with surgery to treat colorectal cancer that has spread to the abdominal lining. However, a recent study compared 30 patients who received surgery with HIPEC to those who received surgery alone. The results showed that both groups had similar survival rates after one year, and the surgery-only group actually recovered faster and spent less time in the hospital. While HIPEC didn’t seem to harm patients, it also didn’t improve their chances of survival in this study, raising questions about whether it’s always necessary.

The Quick Take

  • What they studied: Whether adding a heated chemotherapy treatment (HIPEC) to surgery helps patients with colon cancer that has spread inside the belly survive longer
  • Who participated: 30 patients with colon cancer spread to the abdominal lining: 23 received surgery plus HIPEC, and 7 received surgery alone. The groups were similar in age, health history, and cancer severity
  • Key finding: After one year, patients in both groups had the same survival rates. The surgery-only group recovered faster and left the hospital sooner, suggesting HIPEC didn’t provide extra benefit in this study
  • What it means for you: If you or a loved one faces this diagnosis, this research suggests surgery alone may be a reasonable option worth discussing with your doctor. However, this is a small study, so more research is needed before changing standard treatment practices

The Research Details

This was a retrospective cohort study, meaning researchers looked back at medical records of patients who had already received treatment. They compared two groups: one that received surgery combined with heated chemotherapy (HIPEC) and another that received surgery alone. All patients had the same type of cancer (colorectal cancer that spread to the abdominal lining) and were treated within the same hospital system.

The researchers carefully matched the two groups to make sure they were as similar as possible at the start. They looked at factors like age, sex, previous treatments, cancer markers in the blood, and how advanced the cancer was. This matching helps ensure that any differences in outcomes are due to the treatment itself, not other factors.

The study measured several important outcomes: how long patients stayed in the hospital, whether they needed additional surgeries, complications within 30 days, and whether patients were alive one year after treatment.

This study design is important because it allows researchers to compare real-world outcomes between two treatment approaches. While it’s not as strong as a randomized controlled trial (where patients are randomly assigned to treatments), it provides valuable information about what actually happens to patients in practice. The fact that researchers carefully matched the two groups makes the comparison more reliable.

This study has some important limitations to consider. It’s relatively small (only 30 patients total), which means the results might not apply to all patients. The study only followed patients for one year, so we don’t know about longer-term survival. Because patients weren’t randomly assigned to treatments, there could be hidden differences between groups that affected the results. Additionally, this study was done at one hospital system, so results might differ in other settings or with different chemotherapy doses.

What the Results Show

The main finding was that one year after treatment, both groups had similar survival rates. This was surprising because doctors expected the HIPEC group to do better. The surgery-only group actually had some advantages: they returned to eating regular food faster and spent less time in the intensive care unit.

When researchers looked at complications within 30 days of surgery, both groups had similar rates of problems. This means adding HIPEC didn’t cause more complications, but it also didn’t prevent them. The groups were similar in how long surgery took, how many patients needed additional surgeries, and how long they stayed in the hospital overall.

The cancer patterns were also similar between groups. Researchers tracked where the cancer came back and how quickly, and found no meaningful differences. This suggests that HIPEC didn’t change how the cancer behaved after treatment.

Patients who received HIPEC took longer to return to eating regular food and spent more time in the intensive care unit. These differences suggest that HIPEC added some recovery burden without clear benefit. The study found no differences in the number of organs that needed to be removed during surgery or in the extent of cancer spread at the time of surgery, confirming the groups were well-matched.

This study aligns with a major French clinical trial called PRODIGE 7, which also found that adding HIPEC to surgery didn’t improve survival but did increase recovery time. However, there’s been debate about whether French HIPEC treatments are different from those used in the United States. This study used a US-based HIPEC regimen, providing evidence that the French findings may apply to American practice as well. The results challenge the traditional assumption that more aggressive treatment always leads to better outcomes.

This study is small with only 30 patients, making it difficult to detect real differences if they exist. The study only followed patients for one year, so we don’t know about survival beyond that timeframe. Because patients weren’t randomly assigned to treatments, there could be unmeasured differences between groups that influenced results. The study was conducted at a single hospital system, so results might not apply everywhere. Finally, the small number of patients in the surgery-only group (7 patients) makes it harder to draw firm conclusions about that approach.

The Bottom Line

Based on this research, surgery alone appears to be a reasonable treatment option for colorectal cancer spread to the abdominal lining, with similar one-year survival to surgery plus HIPEC. However, this is preliminary evidence from a small study. Patients should discuss both options with their oncology team, as individual circumstances vary. The evidence suggests HIPEC may not be necessary for all patients, but longer-term studies are needed. Confidence level: Moderate (this is one small study; more research is needed)

This research matters most for patients diagnosed with colorectal cancer that has spread to the abdominal lining and their doctors. It’s particularly relevant for those considering treatment options and wanting to understand the pros and cons of adding HIPEC. Patients concerned about recovery time and hospital stays may find this information especially useful. This doesn’t apply to other cancer types or different stages of colorectal cancer.

In this study, the main outcomes were measured within the first year after treatment. Patients who received surgery alone recovered faster (returning to regular food sooner and leaving intensive care faster), suggesting benefits within weeks. However, the one-year survival rates were similar, meaning the long-term impact wasn’t different in this timeframe. Longer follow-up is needed to understand if differences emerge after one year.

Want to Apply This Research?

  • Track recovery milestones: date returned to regular diet, days in hospital, days until resuming normal activities, and any complications or hospital readmissions. This allows users to compare their recovery trajectory to typical outcomes
  • Users facing this diagnosis can use the app to document their treatment choice (surgery with or without HIPEC), set recovery goals (like returning to regular diet or light activity), and monitor their progress against expected timelines
  • Establish long-term tracking with quarterly check-ins on overall health status, any cancer recurrence, and quality of life measures. Set reminders for follow-up appointments and imaging studies. Track any late complications or changes in health status to contribute to understanding of long-term outcomes

This research summary is for educational purposes only and should not replace professional medical advice. Treatment decisions for colorectal cancer spread to the abdominal lining are complex and should be made in consultation with your oncology team. This study is small and preliminary; discuss all available treatment options, their risks, and benefits with your doctors. Individual circumstances vary, and what works for one patient may not be appropriate for another. Always seek guidance from qualified healthcare professionals before making treatment decisions.