Baratti D, et al. - The role of hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal metastases from colorectal cancer (CRC-PM) was investigated in the Prodige-7 trial. A prospectively collected group of 48 patients undergoing oxaliplatin/irinotecan-based perioperative systemic chemotherapy (s-CT) with targeted agents, and cytoreductive surgery (CRS) (no-HIPEC group) was compared with 48 controls undergoing the same perioperative s-CT and CRS/HIPEC (HIPEC group). According to the Peritoneal Surface Disease Severity Score, completeness of cytoreduction, history of extraperitoneal disease (EPD), and Peritoneal Cancer Index, the patients were matched (1:1). The groups were comparable, except that the HIPEC group had a higher number of patients with World Health Organization performance status 0, pN2 stage primary tumor, and treated with preoperative s-CT. Optimal comprehensive treatment, defined as complete cytoreduction of PM and margin-negative EPD resection, was reported in 41 patients in the no-HIPEC group and 43 patients in the HIPEC group. As per outcomes, selected patients could achieve unexpectedly high survival rates on receiving perioperative s-CT and surgical treatment of CRC-PM. No increase in morbidity was observed in correlation to undergoing mitomycin C-based HIPEC but this had no impact prognosis.