Medical Science
Volume 24, Issue 106, November - December, 2020
Prophylactic HIPEC in colon cancer patients with minimal serosal involvement: A pilot study
Khadiga Amr Abdel Kader1♦, Sherif Ismail Maamoun1, Osman Mohamed Mansour2, Ihab Saad Hussein1, Ghada Mohamed Abdelsalam3, Ahmed Mostafa Ahmed1
1Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt
2Department of Medical Oncology, National Cancer Institute, Cairo University, Egypt
3Department of Pathology, National Cancer Institute, Cairo University, Egypt
♦Corresponding author
Department of Surgical Oncology, National Cancer Institute, Cairo University,
Egypt;
Email: Khadiga.ak@gmail.com
ABSTRACT
Background: In 10%- 35% of patients with recurrent colorectal cancer tumor recurrence is confined to the peritoneal cavity, leading
ultimately to death from complications of loco regional tumoral widespread. Aim: To determine the oncological effectiveness of
prophylactic HIPEC in preventing the development of peritoneal carcinomatosis in colorectal cancer patients having minimal serosal
involvement. Patients and methods: This is a randomized control pilot study on an eligible group of 21 colorectal cancer patients
undergoing a curative colectomy. In which prophylactic HIPEC was administered in the experimental arm, or adjuvant systemic
chemotherapy alone in the standard treatment arm. HIPEC was mitomycin based; it was a 90-minute session and was applied
simultaneously. The effectiveness of prophylactic HIPEC was determined by the peritoneal-recurrence free survival among both
groups at 18 months. Results: The median peritoneal-recurrence free survival for the experimental arm was 17 months, while in the
standard treatment arm it was 12 months (p-value 0.250). There were no perioperative mortalities among both groups, and only one
patient in the experimental arm developed a deep surgical site infection. Conclusion: Prophylactic HIPEC did not seem to have a
major role in the prevention of peritoneal carcinomatosis in colorectal cancer. This statement cannot be made with certainty before
a full-scale randomized control trial is conducted. In addition, to the higher incidence of nodal capsular infiltration among the
experimental arm; this negatively impacts survival and conceals the benefit of HIPEC among the experimental arm.
Keywords: Colorectal cancer, Minimal serosal involvement, peritoneal carcinomatosis, Prophylactic HIPEC.
Medical Science, 2020, 24(106), 4746-4753
