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Hyperthermic Intraperitoneal ChemotherapECO-CHIPNCT07901075

Cost-utility Evaluation of Cytoreductive Surgery With or Without Mitomycin-C Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Resectable Colorectal Peritoneal Metastases

An observational study of Hyperthermic Intraperitoneal Chemotherap and Colorectal Cancer Metastatic, run by Hospices Civils de Lyon.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Official record
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Trial summary

Colorectal cancer is the second leading cause of cancer death in France, with close to 50,000 new cases each year. About half of the patients develop liver, lung and/or peritoneal metastases during the course of the disease.Peritoneal involvement, which accounts for approximately 8,000 new cases per year, carries the… Read more about this study

Who is it for?
Ages 18 years and older
How many people
398 participants
Where
No sites listed yet
Study dates
12 Jan 2027to 12 Dec 2032
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Adult patients with histologically confirmed colorectal cancer and resectable peritoneal metastases, managed surgically in French expert centers for peritoneal surface malignancies.

Who may be able to join

  • Male or female aged 18 years or older.
  • Colorectal cancer with histologically confirmed synchronous or metachronous peritoneal metastases.
  • Peritoneal Cancer Index (PCI) between 5 and 20 inclusive at cytoreductive surgery.
  • Five or fewer associated liver metastases.
  • Indication for complete cytoreductive surgery (CC-0/1), with or without HIPEC according to the routine practice of the center.
  • Maximum of 6 cycles of preoperative neoadjuvant chemotherapy
  • Patient information and non-opposition to data use.

Who cannot join

  • Active cancer of non-colorectal origin, in particular appendiceal.
  • Colorectal adenocarcinoma with signet-ring cells.
  • Person deprived of liberty by a judicial or administrative decision.
  • Adult under a legal protection measure.
  • Criteria for premature withdrawal, assessed intraoperatively at surgical exploration: PCI < 5 or PCI > 20; completeness of cytoreduction (CC) score > 1; more than 5 liver metastases.

About this study

Official title: ECO-CHIP: Cost-utility Evaluation of Cytoreductive Surgery Combined With Mitomycin-C Hyperthermic Intra-Peritoneal Chemotherapy (HIPEC) Versus Cytoreductive Surgery Alone in the Treatment of Resectable Colorectal Peritoneal Metastases. A National, Multicenter, Prospective, Comparative, Non-randomized, Non-interventional Study.

Colorectal cancer is the second leading cause of cancer death in France, with close to 50,000 new cases each year. About half of the patients develop liver, lung and/or peritoneal metastases during the course of the disease.Peritoneal involvement, which accounts for approximately 8,000 new cases per year, carries the poorest prognosis, notably because of its chemoresistance.For patients with resectable colorectal peritoneal metastases,recommended optimal management combines systemic chemotherapy with complete cytoreductive surgery(CRS)in an expert center.Hyperthermic IntraPeritoneal Chemotherapy(HIPEC)may be added to CRS to eradicate residual microscopic disease and potentially improve survival.Clinical evidence on HIPEC for colorectal peritoneal carcinomatosis is heterogeneous and dominated by a randomized trial reporting no survival benefit and increased morbidity, results attributed to the oxaliplatin-based HIPEC regimen used. A separate body of evidence suggests a benefit of mitomycin-C-based HIPEC, with manageable morbidity and preserved quality of life. National and international guidelines therefore allow mitomycin-C HIPEC, but the procedure remains controversial: according to French hospital discharge data, about half of the patients treated for colorectal peritoneal carcinomatosis receive CRS plus HIPEC and the other half CRS alone.HIPEC also raises funding and efficiency issues. No specific French diagnosis-related tariff (GHS)exists for CRS plus HIPEC, whereas the procedure is costly in terms of operating time,human and material resources, and is associated with prolonged hospital stays and complications. To date, no prospective comparative data on the efficiency of CRS plus HIPEC are available in France.ECO-CHIP is a national,multicenter, prospective, comparative,non-randomized, open, non-interventional study using a " here-elsewhere " design (French RIPH category 3). Each participating center follows its own routine practice: centers performing HIPEC treat included patients with CRS plus mitomycin-C HIPEC (innovative strategy), while centers not performing HIPEC treat included patients with CRS alone (reference strategy).No change in management, examination or procedure is imposed by the protocol.the only procedure added because of the research is the completion of self-administered questionnaires (EQ-5D-5L, EORTC QLQ-C30, EORTC QLQ-CR29 and PERI-PROM) at inclusion and at months 1, 3, 6, 12, 18, 24 and 36 after cytoreductive surgery. The primary objective is to assess, from the French health care system perspective and over a 36-month horizon, the efficiency (cost-utility) of cytoreductive surgery combined with mitomycin-C HIPEC versus cytoreductive surgery alone. Costs are derived from micro-costing of the index hospital stay and from individual linkage with the French National Health Data System(SNDS); utilities are derived from the EQ-5D-5L using the French value set. Secondary objectives compare the two strategies in terms of disease-free survival, peritoneal recurrence-free survival, overall survival, toxicity, postoperative complications, recurrence patterns, access to iterative complete cytoreduction, costs, budget impact for the French statutory health insurance, cost-effectiveness at 3 and 5 years, and health-related quality of life.

Study hypothesis: the addition of mitomycin-C HIPEC to complete cytoreductive surgery is an efficient strategy for the French health care system, improving disease-free survival (expected 3-year disease-free survival of 26% with CRS plus HIPEC versus 13% with CRS alone, hazard ratio 0.66) and quality-adjusted survival at an acceptable incremental cost per QALY gained.

Read more

perspective and over a 36-month horizon, the efficiency (cost-utility) of cytoreductive surgery combined with mitomycin-C HIPEC versus cytoreductive surgery alone. Costs are derived from micro-costing of the index hospital stay and from individual linkage with the French National Health Data System (SNDS); utilities are derived from the EQ-5D-5L using the French value set. Secondary objectives compare the two strategies in terms of disease-free survival, peritoneal recurrence-free survival, overall survival, toxicity,postoperative complications, recurrence patterns, access to iterative complete cytoreduction, costs, budget impact for the French statutory health insurance, cost-effectiveness at 3 and 5 years, and health-related quality of life.

Study hypothesis: the addition of mitomycin-C HIPEC to complete cytoreductive surgery is an efficient strategy for the French health care system, improving disease-free survival(expected 3-year disease-free survival of 26% with CRS plus HIPEC versus 13% with CRS alone,hazard ratio 0.66)and quality-adjusted survival at an acceptable incremental cost per QALY gained.A total of 398 patients 199per group are planned for inclusion in French digestive and surgical oncology departments over a 36-month enrolment period, each patient being followed for 36 months

Keywords
Hyperthermic Intraperitoneal Chemotherapy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT07901075
Study groupRoleWhat they receive
CRS plus mitomycin-C HIPEC.Intervention: Cytoreductive Surgery (CRS) plus mitomycin-C HIPEC. Complete cytoreductive surgery (CC-0/1) according to the center's usual standards, followed by intraperitoneal mitomycin C 35 mg/m2 fractionated in 3 doses (50% at T0, 25% at T30, 25% at T60) for 90 minutes at 41-43°C, as a single intraoperative procedure. Intervention: Patient-reported outcome questionnaires (EQ-5D-5L, EORTC QLQ-C30, EORTC QLQ-CR29, PERI-PROM), completed at inclusion and at months 1, 3, 6, 12, 18, 24 and 36. All other care and follow-up visits are performed as part of routine practice.
CRS aloneIntervention: Cytoreductive Surgery (CRS) alone. Complete cytoreductive surgery (CC-0/1) according to the center's usual standards, without HIPEC. Intervention: Patient-reported outcome questionnaires (EQ-5D-5L, EORTC QLQ-C30, EORTC QLQ-CR29, PERI-PROM), completed at inclusion and at months 1, 3, 6, 12, 18, 24 and 36. All other care and follow-up visits are performed as part of routine practice.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incremental Cost-Utility Ratio (ICUR): incremental cost per quality-adjusted life-year (QALY) gained, from the French health care system perspective, at 36 months.

    Ratio of the difference in mean total cost between the two strategies to the difference in mean number of QALYs. Costs are obtained by micro-costing of the index hospital stay and by individual linkage with the French National Health Data System (SNDS). QALYs are computed by the area-under-the-curve method from EQ-5D-5L responses collected at inclusion and at months 1, 3, 6, 12, 18, 24 and 36, valued with the French EQ-5D-5L value set. A 2.5% annual discount rate is applied.

    Measured: 36 months after the initial cytoreductive surgery

Secondary outcomes (13)
  1. Disease-free survival (DFS)

    Time from the initial cytoreductive surgery to the first recurrence or death from any cause, whichever occurs first. Recurrence is defined on clinical, biological and/or imaging criteria and validated by a multidisciplinary tumour board. Participants alive without recurrence are censored at the last evaluation.

    Measured: From the initial cytoreductive surgery up to 36 months

  2. Peritoneal recurrence-free survival

    Time from the initial cytoreductive surgery to the first peritoneal recurrence or death from any cause, whichever occurs first. Peritoneal recurrence is defined on clinical, biological and/or imaging criteria and validated by a multidisciplinary tumour board. Participants alive without peritoneal recurrence are censored at the last evaluation.

    Measured: From the initial cytoreductive surgery up to 36 months

  3. Overall survival (OS)

    Time from the initial cytoreductive surgery to death from any cause. Participants alive are censored at the date of last contact or at the end-of-study date.

    Measured: From the initial cytoreductive surgery up to 36 months (minimum follow-up)

  4. Proportion of participants with at least one treatment-related toxicity

    Proportion of participants presenting at least one toxicity related to oncological treatment, and the associated symptoms, graded according to NCI CTCAE version 5.0.

    Measured: From the initial cytoreductive surgery up to 36 months

  5. Proportion of participants with at least one grade III-IV postoperative surgical complication

    Proportion of participants presenting at least one surgical complication of Dindo-Clavien grade III or IV within 90 days after the initial cytoreductive surgery, including re-hospitalizations.

    Measured: Within 90 days after the initial cytoreductive surgery

  6. Recurrence profile: metastatic sites involved

    Number and proportion of participants presenting a recurrence, and description of the type of recurrence (peritoneal, hepatic, lymph node, other sites).

    Measured: From the initial cytoreductive surgery up to 36 months

  7. Proportion of participants undergoing complete iterative cytoreductive surgery at recurrence

    Among participants presenting a recurrence before 36 months after the initial cytoreductive surgery, proportion considered resectable and operable and actually undergoing a complete iterative cytoreductive surgery.

    Measured: From the initial cytoreductive surgery up to 36 months

  8. Mean cost of the index hospital stay (micro-costing)

    Mean production cost of the index hospital stay for cytoreductive surgery with or without HIPEC, from the health care provider perspective, obtained by micro-costing: identification, measurement and valuation of the resources consumed

    Measured: Index hospital stay, from admission for the initial cytoreductive surgery to hospital discharge

  9. Mean total cost of care per group

    Mean cost of care per participant in each group, from the French health care system perspective, calculated from SNDS data (all reimbursed care from diagnosis, including systemic treatments) combined with the micro-costing of the index stay.

    Measured: From diagnosis up to 36 months after the initial cytoreductive surgery

  10. Budget impact for the French statutory health insurance

    Net benefit (additional costs or savings) for the French statutory health insurance attributable to an increase in the number of HIPEC procedures performed in this indication, comparing the current situation with an alternative scenario of progressive development of CRS plus HIPEC.

    Measured: 5 years

  11. Incremental cost-effectiveness ratio (ICER) at 3 and 5 years

    ICER expressed as incremental cost per life-year gained, from the French health care system perspective. Effectiveness data (3-year and 5-year mortality) are obtained from the electronic case report form and from the SNDS databases.

    Measured: 3 years and 5 years after the initial cytoreductive surgery

  12. Health-related quality of life measured by the EORTC QLQ-C30

    Mean scores of the EORTC QLQ-C30 cancer-specific self-administered questionnaire (global health status, functional scales and symptom scales, each transformed to a 0-100 scale).

    Measured: Inclusion (preoperative consultation), then months 1, 3, 6, 12, 18, 24 and 36 after the initial cytoreductive surgery

  13. Patient-reported outcomes measured by the PERI-PROM questionnaire

    Mean scores of the PERI-PROM questionnaire, the core set of patient-reported outcome measures developed for peritoneal surface malignancies.

    Measured: Inclusion (preoperative consultation), then months 1, 3, 6, 12, 18, 24 and 36 after the initial cytoreductive surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Oct 2026
  2. Study start12 Jan 2027 (estimated)
  3. Primary completion12 Dec 2029 (estimated)
  4. Study completion12 Dec 2032 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
398 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07901075
Sponsor's protocol ID
69HCL25_0884
Acronym
ECO-CHIP
Status last verified
Oct 2026
First submitted
21 Oct 2026
Last updated
28 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

An observational study of Hyperthermic Intraperitoneal Chemotherap and Colorectal Cancer Metastatic, run by Hospices Civils de Lyon.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 28 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incremental Cost-Utility Ratio (ICUR): incremental cost per quality-adjusted life-year (QALY) gained, from the French health care system perspective, at 36 months. (time frame: 36 months after the initial cytoreductive surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Oct 2026.

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