Perioperative Systemic Therapy vs Surgery and HIPEC Alone fo
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The result of this JAMA study suggests that perioperative systemic therapy seems feasible and safe in patients diagnosed with resectable colorectal peritoneal metastases (CPM).

The objective of this study was to assess the feasibility and safety of perioperative systemic therapy in patients with resectable CPM and the response of CPM to neoadjuvant treatment.

An open-label, parallel-group phase 2 randomized clinical trial in all 9 Dutch tertiary centers for the surgical treatment of CPM enrolled participants. Participants were patients with pathologically proven isolated resectable CPM who did not receive systemic therapy within 6 months before enrollment.

--In 79 patients included in the analysis, experimental (n=37) and control (n=42) arms did not differ significantly regarding the proportions of macroscopic complete CRS-HIPEC and Clavien-Dindo grade 3 or higher postoperative morbidity.

--No treatment-related deaths occurred.

--Objective radiologic and major pathologic response rates of CPM to neoadjuvant treatment were 28% and 38%, respectively.

In this randomized phase 2 trial in patients diagnosed with resectable CPM, perioperative systemic therapy seemed feasible, safe, and able to induce CPM response, justifying a phase 3 trial.

Source: https://jamanetwork.com/journals/jamasurgery/article-abstract/2780041
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