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PRODIGE 7 tested whether adding oxaliplatin-based hyperthermic intraperitoneal chemotherapy to cytoreductive surgery improved outcomes for patients with colorectal peritoneal metastases. All patients underwent an attempt at complete cytoreduction and received modern systemic chemotherapy; they were then randomized to surgery alone or surgery plus HIPEC. The trial found no significant overall-survival advantage from adding the HIPEC regimen. The result is important because it challenges the assumption that more extensive intraperitoneal treatment automatically produces better outcomes. Complete cytoreduction remained the cornerstone, while the incremental value of this specific HIPEC approach was not demonstrated. The study also highlighted the importance of postoperative morbidity and recovery when considering an aggressive combined strategy. For surgical teams, the practical lesson is to evaluate peritoneal-disease burden, the feasibility of complete cytoreduction, patient fitness and available expertise rather than treating HIPEC as a routine add-on. Other HIPEC regimens and highly selected clinical situations may still be relevant, but PRODIGE 7 strongly supports evidence-based patient selection and multidisciplinary decision-making.
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PRODIGE 7 tested whether adding oxaliplatin-based hyperthermic intraperitoneal chemotherapy to cytoreductive surgery improved outcomes for patients with colorectal peritoneal metastases. All patients underwent an attempt at complete cytoreduction and received modern systemic chemotherapy; they were then randomized to surgery alone or surgery plus HIPEC. The trial found no significant overall-survival advantage from adding the HIPEC regimen. The result is important because it challenges the assumption that more extensive intraperitoneal treatment automatically produces better outcomes. Complete cytoreduction remained the cornerstone, while the incremental value of this specific HIPEC approach was not demonstrated. The study also highlighted the importance of postoperative morbidity and recovery when considering an aggressive combined strategy. For surgical teams, the practical lesson is to evaluate peritoneal-disease burden, the feasibility of complete cytoreduction, patient fitness and available expertise rather than treating HIPEC as a routine add-on. Other HIPEC regimens and highly selected clinical situations may still be relevant, but PRODIGE 7 strongly supports evidence-based patient selection and multidisciplinary decision-making.
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