In our experience, PD prior to SPK transplantation is not associated with increased incidence of intra-abdominal infection compared to HD.

Background The French PRODIGE 7 trial, published on January 2021, has raised doubts about the specific survival benefit provided by HIPEC with oxaliplatin 460 mg/m2 (30 minutes) for the treatment of peritoneal metastases from colorectal cancer. However, several methodological flaws have been identified in PRODIGE 7, specially the HIPEC protocol or the choice of overall survival as the main endpoint, so its results have not been assumed as definitive, emphasizing the need for further research on HIPEC. It seems that the HIPEC protocol with high-dose mytomicin-C (35 mg/m2) is the preferred regime to evaluate in future clinical studies. Methods GECOP-MMC is a prospective, open-label, randomized, multicenter phase IV clinical trial that aims to evaluate the effectiveness of HIPEC with high-dose mytomicin-C in preventing the development of peritoneal recurrence in patients with limited peritoneal metastasis from colon cancer (not rectal), after complete surgical cytoreduction. This study will be performed in 31 Spanish HIPEC centres, starting in March 2022. Additional international recruiting centres are under consideration. Two hundred sixteen patients with PCI ≤ 20, in which complete cytoreduction (CCS 0) has been obtained, will be randomized intraoperatively to arm 1 (with HIPEC) or arm 2 (without HIPEC). We will stratified randomization by surgical PCI (1–10; 11–15; 16–20). Patients in both arms will be treated with personalized systemic chemotherapy. Primary endpoint is peritoneal recurrence-free survival at 3 years. An ancillary study will evaluate the correlation between surgical and pathological PCI, comparing their respective prognostic values. Discussion HIPEC with high-dose mytomicin-C, in patients with limited (PCI ≤ 20) and completely resected (CCS 0) peritoneal metastases, is assumed to reduce the expected risk of peritoneal recurrence from 50 to 30% at 3 years. Trial registration EudraCT number: 2019–004679-37; Clinicaltrials.gov: NCT05250648 (registration date 02/22/2022, ).

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Traditionally, peritoneal carcinomatosis (PC) was regarded as an untreatable condition; however, the introduction of locoregional therapies combining cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) approximately two decades ago has changed this view. There is controversy, however, when a PC arises from pancreatic cancer. We have reported on an extraordinary case of an aggressive pseudomixoma peritonei arising from an invasive intraductal papillary mucinous neoplasm (IPMN) treated with complete cytoreduction and HIPEC. This combination of treatments has not been previously described. Moreover, a very long-term disease-free survival of up to 70 months has been achieved by this combined approach. This approach may provide some optimism for considerable life extension in selected patients who present with an aggressive peritoneal mucinous carcinomatosis of pancreatic origin considered suitable only for palliative care.

PSDSS was capable of identifying a better surviving patient population in advanced-stage OEC. While randomized trials to evaluate the benefit of HIPEC are needed, the PSDSS may be a useful tool for selecting and stratifying OEC patients in clinical trials. J. Surg. Oncol. 2016;114:779-784. © 2016 2016 Wiley Periodicals, Inc.