PRODIGE 7

PRODIGE 7 randomised 265 patients at 17 French centres who had achieved complete macroscopic resection of colorectal peritoneal metastases to oxaliplatin-based HIPEC (360 mg/m2 closed or 460 mg/m2 open abdomen, with intravenous fluorouracil and folinic acid 20 minutes before) or to no HIPEC. After a median 63.8 months, median overall survival was 41.7 against 41.2 months (hazard ratio 1.00, 95.37% CI 0.63 to 1.58, p=0.99). Grade 3 or worse adverse events at 60 days were more common with HIPEC (26 against 15 percent, p=0.035). Both arms did far better than historical series treated with chemotherapy alone, which is the trial's positive message: complete cytoreductive surgery in selected patients gives a median survival above three years. HIPEC with oxaliplatin does not add to it, and COLOPEC and PROPHYLOCHIP separately showed it does not work as prophylaxis either.