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Tumori. 2019 Aug 30:300891619868013. doi: 10.1177/0300891619868013. [Epub ahead of print]

Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) in patients with peritoneal metastasized colorectal, appendiceal and small bowel cancer.

Author information

1
Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
2
University Cancer Center Leipzig, University Hospital of Leipzig, Leipzig, Germany.
3
Institute of Pathology, University Hospital of Leipzig, Leipzig, Germany.

Abstract

BACKGROUND:

Patients with intestinal cancer (colorectal, appendiceal, and small bowel) with peritoneal metastases (PM) have a poor prognosis. We assessed whether pressurized intraperitoneal aerosol chemotherapy (PIPAC) together with systemic chemotherapy is an effective treatment option for these entities in palliative intent.

METHODS:

Between November 2015 and February 2018, prospective data registry was performed (NCT03100708). Thirteen patients with intestinal cancer (median age 61 years [range 49-77]) underwent 26 PIPAC procedures with a median number of 2 interventions per patient (range 1-6). A chemoaerosol consisting of cisplatin/doxorubicin was administered during standard laparoscopy.

RESULTS:

The median peritoneal carcinomatosis index according to Sugarbaker before the first PIPAC was 14 (range 2-27), and the median ascites volume was 10 mL (range 0-6300 mL). Six patients who received 2 or more PIPAC procedures had decreased and stable ascites volumes, while only 1 patient displayed increased ascites. The median overall survival was 303 days (range 30-490) after the first PIPAC procedure.

CONCLUSIONS:

PIPAC offers a novel treatment option for patients with PM. Our data show that PIPAC is safe and well-tolerated. Ascites production can be controlled by PIPAC in patients with intestinal cancer. Further studies are required to document the significance of PIPAC within palliative therapy concepts.

TRIAL REGISTRATION:

NCT03100708.

KEYWORDS:

Colorectal cancer; appendiceal cancer; palliative chemotherapy; peritoneal metastasis; pressurized intraperitoneal aerosol chemotherapy; small bowel cancer

PMID:
31469058
DOI:
10.1177/0300891619868013

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