Hyperthermic Intraperitoneal Chemotherapy and Recirculation with CO₂: A Safe Technique

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Hyperthermic IntraPEritoneal Chemotherapy (HIPEC) is a key treatment for peritoneal carcinomatosis following cytoreductive surgery.
• HIPEC has shown improved survival outcomes compared to traditional therapies.
• Evaluating novel HIPEC delivery systems is crucial for optimizing patient outcomes.

Purpose of the Study:

• To assess the safety, efficacy, and survival rates of a closed HIPEC technique using the CO2-agitation system Combat PRS®.
• To compare these outcomes against traditional open and closed HIPEC methods.

Main Methods:

• A retrospective study involving 482 patients across 11 Spanish hospitals.
• HIPEC was administered using the closed Combat PRS® system with CO2 recirculation.
• Outcomes analyzed included overall survival (OS), disease-free survival (DFS), morbidity, and mortality.

Main Results:

• Mortality rate was 1.66%, comparable to other HIPEC techniques.
• Morbidity rate of Clavien-Dindo (CD) III/IV complications was 9.96%, lower than reported for other series.
• Survival rates were 86% 1-year OS, 54% 3-year OS, 77% 1-year DFS, and 31% 3-year DFS.

Conclusions:

• The closed HIPEC technique with CO2 agitation (Combat PRS®) is as safe as standard open and closed procedures.
• This method achieves similar, very low mortality (1.66%) and reduced morbidity (9.96% CD III/IV complications).
• It offers comparable survival outcomes, representing a safe and effective option for HIPEC delivery.