Long-term survival after HIPEC with mitomycin C versus oxaliplatin in patients with colorectal peritoneal metastases
In brief
Mitomycin C HIPEC was linked to 3.6 more months before peritoneal recurrence
In this single-center retrospective study of 366 patients, median time without peritoneal disease was 14.9 months with mitomycin C HIPEC versus 11.3 months with oxaliplatin HIPEC, with no overall survival difference between treatments. Prior systemic oxaliplatin was linked to poorer outcomes among oxaliplatin HIPEC recipients, but the findings need confirmation beyond this observational cohort.
- Journal
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Q1)
- Published
- 8 October 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Lizzel van der Snee, Arend G J Aalbers, Petur Snaebjornsson, Brechtje A Grotenhuis, Patricia D Bottenberg, Marta Lopez-Yurda, et al.
- PMID
- 42874308
- DOI
- 10.1016/j.ejso.2026.112198
Why clinicians should know about it
- Picked for Surgical Oncology (paper of the day, 20 October 2026): Mitomycin C HIPEC better peritoneal DFS
Abstract
BACKGROUND: Cytoreductive surgery (CRS) and oxaliplatin-based hyperthermic intraperitoneal chemotherapy (HIPEC) is controversial in patients with colorectal peritoneal metastases, particularly in those who have received prior systemic oxaliplatin. In the Netherlands, upfront CRS-HIPEC remains the preferred treatment. The aim was to compare the survival of patients with colorectal peritoneal metastases treated with CRS and mitomycin C versus oxaliplatin-based HIPEC. METHODS: This was a retrospective, single-center cohort study of consecutive patients with colorectal peritoneal metastases who underwent macroscopic complete CRS-HIPEC between 2010 and 2023. Main outcomes were differences in disease-free, peritoneal disease-free, distant disease-free, and overall survival. RESULTS: Of 366 patients included, 153 and 213 underwent mitomycin C-based and oxaliplatin-based HIPEC, respectively. Most patients (68.6%) underwent upfront CRS-HIPEC. Median follow-up was 58.7 months (range, 24.8 - 175.1) and median overall survival was 43.3 months (95% CI, 36.5 - 49.9). In multivariable analyses, oxaliplatin-based HIPEC was associated with worse peritoneal disease-free survival compared to mitomycin C-based HIPEC (median 11.3 vs. 14.9 months; HR 1.44, 95% CI, 1.09 - 1.90; P = .010). No difference was observed in disease-free, distant disease-free, and overall survival. Among patients treated with oxaliplatin-based HIPEC, prior systemic oxaliplatin exposure was associated with worse peritoneal disease-free survival (median 8.7 vs. 13.1 months; HR 1.59, 95% CI, 1.10 - 2.31; P = .014) and overall survival (median 35.7 vs. 50.6 months; HR 1.55, 95% CI, 1.07 - 2.23; P = .020) compared to no prior oxaliplatin exposure. CONCLUSIONS: Oxaliplatin-based HIPEC was associated with a higher risk of peritoneal recurrence, particularly in patients previously treated with systemic oxaliplatin. Mitomycin C-based HIPEC is a better choice in this subgroup.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.