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Dr Vijayvergia Discusses the Role of HIPEC in CRS
Namrata Vijayvergia, MD, FACP, Fox Chase Cancer Center, discusses whether or not the role for HIPEC is necessary for cytoreductive surgery, a debate presented at the 2022 Great Debates and Updates in Gastrointestinal Malignancies.
Transcript
Hello, everyone. My name is Namrata Vijayvergia. I am a GI medical oncologist at Fox Chase Cancer Center, and I’m very excited to be at the Great Debates and Updates this year in 2022, live in New York.
So I was entasked with two debates, and one was to assess the role of HIPEC with CRS in colorectal cancer. And I was supposed to talk about that there's no role of HIPEC. And the second one was to look at if there's a role for any systemic therapy after colorectal liver metastasis resection.
The second thing we talked about was is there a role of HIPEC with CRS. So cytoreductive surgery is offered to patients with limited peritoneal disease after colorectal cancer metastases. And we always do it with HIPEC rather than alone. And it has always been studied as a group rather than individually. And the one study that actually did compare the role of each of these therapies, so CRS and HIPEC separately, which was the PRODIGE 7 Trial, did not find any difference between the survival in patients who just got cytoreductive surgery or those who got cytoreductive surgery with HIPEC.
Obviously, adding intra-peritoneal chemotherapy led to toxicities, mainly neutropenia, and the time it took for those patients who recover and get back on systemic therapy, which we know definitely helps, was much longer in the CRS plus HIPEC arm. So again, there's a potential we could harm patients. Benefit is questionable. So doing HIPEC with CRS is not really that helpful. But I don't want to throw the baby with the bath water and say, it's no longer helpful. We just need to do better. We need to find in the right patients. We need to see if there are subgroups of patients who are going to respond and go from there. So thank you.
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