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The trial that took the heated chemotherapy away and found the survival was the same: 41.7 against 41.2 months. The benefit had always been in the surgery.
Quénet, Elias, Roca and colleagues ran a randomised open-label phase 3 trial at 17 cancer centres in France in patients aged 18 to 70 with histologically proven colorectal cancer and peritoneal metastases, WHO performance status 0 or 1, a Peritoneal Cancer Index of 25 or less, and eligibility for six months of systemic chemotherapy. Patients in whom complete macroscopic resection, or resection with less than 1 mm of residual tumour, was achieved were randomised 1:1 to cytoreductive surgery with or without oxaliplatin-based hyperthermic intraperitoneal chemotherapy. All patients received systemic chemotherapy with or without targeted therapy before or after surgery, or both. The primary endpoint was overall survival in the intention-to-treat population.
Between February 2008 and January 2014, 265 patients were randomised: 133 to surgery plus hyperthermic intraperitoneal chemotherapy and 132 to surgery alone.
Complete cytoreductive surgery with modern systemic chemotherapy gives a median survival over 40 months in selected patients with peritoneal metastases, and the heated intraperitoneal oxaliplatin adds only late complications.
Shares Leucovorin (folinic acid), Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Fluorouracil (5-FU), Colorectal cancer and the tag colorectal-evidence.
Shares UNICANCER, Oxaliplatin, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, The Lancet Oncology and the tag colorectal-evidence.
Shares Surgery and radiotherapy cure most, get least, Oxaliplatin, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Colorectal cancer and the tag colorectal-evidence.
Shares Leucovorin (folinic acid), Oxaliplatin, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Fluorouracil (5-FU) and the tag colorectal-evidence.
Shares Surgery and radiotherapy cure most, get least, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Fluorouracil (5-FU), Colorectal cancer and the tag colorectal-evidence.
Shares Surgery and radiotherapy cure most, get least, Oxaliplatin, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, The Lancet Oncology and the tag colorectal-evidence.
Shares Leucovorin (folinic acid), Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Fluorouracil (5-FU), Colorectal cancer and the tag colorectal-evidence.
Shares Oxaliplatin, The Lancet Oncology, Fluorouracil (5-FU), Colorectal cancer and the tag colorectal-evidence.