Effectiveness and safety of HIPEC for colorectal peritoneal metastasis: a systematic review

eview question / Objective Population: Patients aged ≥18 years with advanced colorectal cancer (CRC), stratified into two clinical settings: (1) therapeutic setting-patients with established peritoneal metastasis (CRC-PM);(2) prophylactic/adjuvant setting-patients with high-risk locally advanced CRC (e.g., T4 or perforated) without established PM.Intervention: Hyperthermic intraperitoneal c h e m o t h e r a p y ( H I P E C ) a d m i n i s t e re d v i a intraperitoneal perfusion at ≥41°C for ≥30 minutes, with various chemotherapeutic agents (oxaliplatin, mitomycin C, fluorouracil, etc.), either combined with cytoreductive surgery (CRS) or systemic chemotherapy.Comparison: Control groups receiving no HIPEC, including CRS alone, systemic chemotherapy alone, routine surveillance, or palliative care. Outcomes: Primary outcome-overall survival (OS); secondary outcomes-disease-free survival (DFS)/progression-free survival (PFS), peritoneal metastasis (PM) rate, and adverse events (AEs).Study design: Randomized controlled trials (RCTs) published in English or Chinese.Objective: To systematically evaluate the efficacy and safety of HIPEC for advanced CRC through a meta-analysis of RCTs, with prespecified stratification by clinical setting (therapeutic vs. prophylactic/adjuvant) to provide robust evidence for clinical decision-making regarding HIPEC use in CRC-PM and high-risk locally advanced CRC patients. INPLASY 1International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY Effectiveness and safety of HIPEC for colorectal peritoneal metastasis: a systematic reviewYang, XY; Duan, XL.