Adjuvant hyperthermic intraperitoneal chemotherapy in locally advanced colorectal cancer: A propensity score matched cohort study

Abstract

Abstract Background The benefit of the application of adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) to the prognosis of locally advanced colorectal cancer (CRC) patients is unclear. Methods In total, 3008 consecutive CRC patients who underwent resection at Nanfang Hospital from September 2013 to May 2018 were analyzed. After Propensity score matching (PSM), the HIPEC group (n = 188) and control group (n = 188) were compared by surgical outcomes, complications, and long-term survival. Uni- and multivariate analyses were conducted to confirm the role of HIPEC in the prognosis. Results After PSM, there were no statistically significant differences in all the baseline parameters between two groups. However, the operation time in the HIPEC group was longer. Regarding recovery courses, the HIPEC group takes more time. There was no significant difference between the two groups regarding intra-abdominal infection, ileus, intestinal fistula, anastomotic leakage, lymphatic leakage, pancreatic fistula, uroschesis, pulmonary infection, urinary infection, and cerebrovascular events. However, wound infection was more severe in the HIPEC group than in the control group. The 3-year overall survival (OS) and disease-free survival (DFS) rates, respectively, were 87.2% and 81.7% in the HIPEC group, and 80.5% and 75.2% in the control group. Multivariate analyses revealed that HIPEC, ASA score > II, laparoscopic approach and advanced tumor T and N stages were independent predictive factors for superior OS and DFS. Conclusions Adjuvant HIPEC with more reasonable regimens, cycles, and duration could independently improve the prognosis in patients with locally advanced CRC.