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Aprospective study was undertaken to evaluate the effectiveness of intra-operative pelvic hyperthermic chemotherapy (IOPHC) for rectal cancer in terms of the reduction of recurrence rate after surgery.Between 2003-2010, 114 patients were included in the study. All these rectal carcinomas were locally advanced tumours of the mid-and low rectum with involvement of rectal fascia. Patients were allocated into two arms (IOPHC + surgery and surgery only) with 57 patients in each. IOPHC performed using a solution containing 150 mg of cisplatin in 1000 ml of saline, at 44.0-45.0°C for 60 min.There was no evidence of IOPHC related toxicity. Morbidity in the main group was 17.5% vs 15.8% in controls (P = 1.0). Local recurrences developed in 4 (7%) patients in the IOPHC + surgery group and in seven patients (12.3%) in the control group (P = 0.52). At a median follow up of 28 months, the 3-year survival rate was 72.8 ± 11.7% in IOPHC and 62.5 ± 13.6% in controls (P = 0.65).The data from our study testify the safety of IOPHC. A tendency towards better local control and 3-year DFS has been found. Confirmation of the potential advantages of IOPHC needs larger groups of patients and longer follow up.