Breakout Session: The Latest Updates on HIPEC for Gastrointestinal Cancers
George J. Chang, MD, MS—Chair
The University of Texas MD Anderson Cancer Center
Charles A. Staley, MD
Winship Cancer Institute, Emory University • cstaley@emory.edu
Understanding the RCT Data from HIPEC for Colorectal Cancer: An Opportunity?
Conclusions:
• A minority of patients with PM alone are referred for CRS/HIPEC, time of referral important
• PMs respond to systemic chemotherapy differently than other sites of metastases
• Prodige 7 benefit of CRS 4 year median survival, but no benefit of 30min hyperthermia and IP oxaliplatin
• COLOPEC adjuvant HIPEC results later today • ProphyloCHIP- no benefit of prophylactic HIPEC
• Swedish trial suggests benefit of EPIC, Dr Nash's trial will add knowledge to EPIC vs HIPEC
• Histology, burden of disease(PCI), CC important
• We need RCTs looking at American CRS/HIPEC including Mitomycin and extended hyperthermia 90-120 min.
• Many questions remain, US HIPEC surgeons are organized and ready to participate
• Medical Oncologists and Surgical Oncologists must work together to develop the most important clinical trials
• lt you would like to join the National CRS/HIPEC working group through the cooperative groups
Franco Roviello, MD, FACS
University of Siena
Optimal Patient Selection for HIPEC for Metastatic Gastric Cancer
Conclusions:
• Cytoreduction and HIPEC should be considered for some gastric PC as a curative approach
- synchronous
- complete cytoreductive surgery CC-0
- PCI less than 6
• Prophylactic HIPEC for high-risk CATEGORIES should confirm its
• HIPEC may eventually become an accepted treatment strategy for select patients presenting with GC-PC in terms of morbidity/mortality
• Molecular Biology can predict model for recurrence: better selection of cases and responders