Research Spotlight: Multicenter Study Strengthens Case for CRS/HIPEC in Peritoneal Metastases from Small Bowel Adenocarcinoma

Abdominal Cancers Alliance
Jul 24
2 min read

Marco Tonello MD, PhD, Carola Cenzi MS, PhD, Elisa Pizzolato MD, Manuela Martini RN,

Pierluigi Pilati MD & Antonio Sommariva MD

Ann Surg Oncol 32, 5795–5806 (2025). https://doi.org/10.1245/s10434-025-17518-z

Why This Matters

Small bowel adenocarcinoma (SBA) is rare, aggressive, and often diagnosed at an advanced stage—leaving patients with limited options and poor prognoses. Peritoneal metastases (PM) from SBA are particularly challenging, and until recently, there has been little data to support more aggressive treatment approaches. That’s why this new international multicenter study, published in the Annals of Surgical Oncology, is a significant step forward.

What the Study Found

Researchers from 11 high-volume HIPEC centers across Europe and the U.S. reviewed outcomes from 176 patients with SBA and peritoneal metastases treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The study is the largest of its kind focused on this patient population.

Key findings include:

Median overall survival was 32 months, with a 5-year overall survival rate of 30%.
Patients who underwent complete cytoreduction (CC-0/1) had significantly better outcomes than those with incomplete surgery.
Postoperative morbidity was acceptable, with major complications in 23% of cases and a 30-day mortality rate of just 1.7%.
These outcomes are notably improved compared to historical survival rates of 8–20 months using systemic therapy alone.

Why It’s Important

This study reinforces that, in select patients, CRS/HIPEC can provide meaningful long-term survival—even for those with metastatic SBA, which has historically been considered incurable. The data offer new hope and a stronger foundation for discussing surgical options with patients facing this difficult diagnosis.

What It Means for Patients

At the Abdominal Cancers Alliance, we believe in the power of research to change lives. This study adds to a growing body of evidence supporting CRS/HIPEC as a potentially life-extending treatment for certain rare abdominal cancers. It also underscores the importance of seeing specialists at high-volume centers who have experience in these complex procedures.