Dr. Lee on the Benefit of Cytoreductive Surgery in Metastatic Colorectal Cancer

Byrne Lee, MD, chief, Upper GI and Mixed Tumor Surgery Service, associate professor of surgical oncology, City of Hope, discusses the benefit of cytoreductive surgery in the treatment of patients with metastatic colorectal cancer (mCRC).

At the 2018 Gastrointestinal Cancers Symposium, the results of the PRODIGE 7 trial were presented by a large French group. The trial examined the use of cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy (HIPEC) for the treatment of patients with peritoneal metastases, says Lee. Patients were randomized to receive either surgery alone or surgery with HIPEC; this utilized a more European regimen comprised of oxaliplatin perfused for 30 minutes at 43° Celsius.

There was no improvement in overall survival or progression-free survival (PFS) when HIPEC was used, states Lee. However, the trial did show that cytoreductive surgery is effective, with a median PFS of approximately 40 months in both arms. Based on these results, physicians believe that with appropriate patient selection, cytoreductive surgery confers benefit for patients with peritoneal metastases.