Year 2020 / Volume 112 / Number 8
Letter
Prophylactic HIPEC with oxaliplatin might be of benefit in T4 and perforated colon cancer: another possible interpretation of the COLOPEC results

666

DOI: 10.17235/reed.2020.6755/2019

Juan José Segura-Sampedro, Rafael Morales-Soriano,

Abstract
The COLOPEC trial failed to show evidence for improved relapse-free survival (RFS) between the two study groups: 80,9% (95% CI 73.3–88.5) in the experimental group and 76.2 % (68.0-84.4) in the control group (one-sided log-rank p = 0.28). Nevertheless only 87 patients received the adjuvant HIPEC treatment in the experimental arm (n = 100). This group had a peritoneal relapse of 19 %, but only 10 % had a truly peritoneal relapse as 9 of them had stablished peritoneal carcinomatosis and 1 case was a peritoneal recurrence but did not receive adjuvant HIPEC. We conducted a per-protocol analysis comparing the 87 patients which truly received the adjuvant HIPEC to the 102 patients in the control arm and obtained an OR 0.396 (95 % CI 0.17–0.91) with a (Pearson Chi-Square p = 0.026, two-tailed Fisher exact test p = 0.032). This contradicts the COLOPEC reported conclusions and shows that adjuvant HIPEC could have an important protective role against peritoneal recurrence.
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References
[1] Klaver CEL, Musters GD, Bemelman W et al. Adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with colon cancer at high risk of peritoneal carcinomatosis; the COLOPEC randomized multicentre trial. BMC Cancer 2015;15:428. https://doi.org/10.1186/s12885-015-1430-7.
[2] Klaver CEL, Wisselink DD, Punt CJA, et al. Adjuvant hyperthermic intraperitoneal chemotherapy in patients with locally advanced colon cancer (COLOPEC): a multicentre, open-label, randomised trial. Lancet Gastroenterol Hepatol 2019;4:761–70. https://doi.org/10.1016/s2468-1253(19)30239-0.
[3] Shah PB. Intention-to-treat and per-protocol analysis. CMAJ 2011;183:696; author reply 696. https://doi.org/10.1503/cmaj.111-2033.
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Segura-Sampedro J, Morales-Soriano R. Prophylactic HIPEC with oxaliplatin might be of benefit in T4 and perforated colon cancer: another possible interpretation of the COLOPEC results . 6755/2019


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Publication history

Received: 18/11/2019

Accepted: 10/12/2019

Online First: 20/07/2020

Published: 30/07/2020

Article revision time: 18 days

Article Online First time: 245 days

Article editing time: 255 days


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