Second-look surgery plus hyperthermic intraperitoneal chemotherapy versus surveillance in patients at high risk of developing colorectal peritoneal metastases (PROPHYLOCHIP–PRODIGE 15): a randomised, phase 3 study
RCT (n=150) found that second-look surgery plus oxaliplatin- hyperthermic intraperitoneal chemotherapy did not improve disease-free survival compared with standard surveillance (3 year disease survival 53% vs 44%, HR 0.97, 95% CI 0.61-1.56).
Source:
The Lancet Oncology
SPS commentary:
Authors highlight that currently, essential surveillance of patients at high risk of developing colorectal peritoneal metastases appears to be adequate and effective in terms of survival outcomes.
A related commentary concurs with the authors’ conclusions, that second look surgery is not required, provided that primary surgery is optimal Perhaps follow-up should be intensified for high-risk groups, but all oncologists, surgeons, and multidisciplinary teams should be very aware that no imaging modality is sensitive, or specific, for peritoneal metastases. The abdominal cavity remains a surprise for all who dare to enter, but surgeons will be grateful there is no need for routine second look.