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Feasibility and Safety of Oxaliplatin-Based Pressurized Intraperitoneal Aerosol Chemotherapy With or Without Intraoperative Intravenous 5-Fluorouracil and Leucovorin for Colorectal Peritoneal Metastases: A Multicenter Comparative Cohort Study

  • Peritoneal Surface Malignancy
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This retrospective multicenter cohort study compared the feasibility and safety of oxaliplatin-based pressurized intraperitoneal aerosol chemotherapy (PIPAC-Ox) with or without intraoperative intravenous 5-fluorouracil (5-FU) and leucovorin (L).

Methods

Our study included consecutive patients with histologically proven unresectable and isolated colorectal peritoneal metastases (cPM) treated with PIPAC-Ox in seven tertiary referral centers between January 2015 and April 2020. Toxicity events and oncological outcomes (histological response, progression-free survival, and overall survival) were compared between patients who received intraoperative intravenous 5-FU/L (PIPAC-Ox + 5-FU/L group) and patients who did not (PIPAC-Ox group).

Results

In total, 101 patients (263 procedures) were included in the PIPAC-Ox group and 30 patients (80 procedures) were included in the PIPAC-Ox + 5-FU/L group. Common Terminology Criteria for Adverse Events v4.0 grade 2 or higher adverse events occurred in 48 of 101 (47.5%) patients in the PIPAC-Ox group and in 13 of 30 (43.3%) patients in the PIPAC-Ox + 5-FU/L group (p = 0.73). The complete histological response rates according to the peritoneal regression grading score were 27% for the PIPAC-Ox + 5-FU/L group and 18% for the PIPAC-Ox group (p = 0.74). No statistically significant differences were observed in overall or progression-free survival between the two groups.

Conclusions

The safety and feasibility of PIPAC-Ox + 5-FU/L appears to be similar to the safety and feasibility of PIPAC-Ox alone in patients with unresectable cPM. Oncological outcomes must be evaluated in larger studies.

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Funding

No sources of funding were used to assist in the preparation of this study.

Author information

Authors and Affiliations

  1. Digestive Surgery Department, Dupuytren Limoges University Hospital, Limoges, France

    Abdelkader Taibi MD, PhD & Sylvaine Durand Fontanier MD

  2. CNRS, XLIM, UMR 7252, University Limoges, Limoges, France

    Abdelkader Taibi MD, PhD, Sylvia M. Bardet PhD & Sylvaine Durand Fontanier MD

  3. Department of Surgical Oncology, Cancer Institute Montpellier (ICM), University of Montpellier, Montpellier, France

    Olivia Sgarbura MD, PhD & François Quenet MD

  4. IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut régional du Cancer de Montpellier, Montpellier, France

    Olivia Sgarbura MD, PhD

  5. Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland

    Martin Hübner MD, Basile Pache MD & Hugo Teixeira Farinha MD

  6. Department of General Surgery and Surgical Oncology, Lyon Sud University Hospital, Pierre Benite, France

    Mohammed Alyami MD

  7. Department of General Surgery and Surgical Oncology, King Khalid Hospital, Najran, Saudi Arabia

    Mohammed Alyami MD

  8. Department of General Surgery and Surgical Oncology, Lyon Sud University Hospital, Pierre Benite, France

    Naoual Bakrin MD, PhD & Olivier Glehen MD, PhD

  9. Department of General Surgery, University Hospital Lille, Lille, France

    Clarisse Eveno MD, PhD

  10. Department of General Surgery, University Hospital Clermont-Ferrand, Clermont-Ferrand, France

    Johan Gagniere MD, PhD

  11. INSERM U1275, CAP Paris-Tech, Carcinomatosis Peritoneum Paris Technology, Lariboisière Hospital, AP-HP, Paris 7 –Diderot University, Sorbonne Paris Cité, Paris, France

    Marc Pocard MD, PhD

  12. Hepato-Biliary-Pancreatic Gastrointestinal Surgery and Liver Transplantation Pitié-Salpêtrière Hospital Assistance Publique/Hôpitaux de Paris, 75013, Paris, France

    Marc Pocard MD, PhD

  13. Department of Surgical Oncology, Institut de Cancérologie de l’Ouest, Saint Herblain, France

    Emilie Thibaudeau MD & Frederic Dumont MD, PhD

Authors
  1. Abdelkader Taibi MD, PhD
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  2. Olivia Sgarbura MD, PhD
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  3. Martin Hübner MD
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  4. Sylvia M. Bardet PhD
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  5. Mohammed Alyami MD
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  6. Naoual Bakrin MD, PhD
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  7. Sylvaine Durand Fontanier MD
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  8. Clarisse Eveno MD, PhD
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  9. Johan Gagniere MD, PhD
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  14. Emilie Thibaudeau MD
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  15. Frederic Dumont MD, PhD
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  16. Olivier Glehen MD, PhD
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Contributions

AT, FD, OG, OS and MH: Conceptualization, patient management, database, methodology, writing – original draft, and review. SMB, MA, NB, SD, CE, JG, BP, MP, FQ, HTF, and ET: Patient management and database review. All authors: Review of the manuscript.

Corresponding author

Correspondence to Abdelkader Taibi MD, PhD.

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Disclosures

Olivier Glehen is consultant for Gamida. Abdelkader Taibi, Olivia Sgarbura, Martin Hübner, Sylvia M. Bardet, Mohammed Alyami, Naoual Bakrin, Sylvaine Durand Fontanier, Clarisse Eveno, Johan Gagniere, Basile Pache, Marc Pocard, François Quenet, Hugo Teixeira Farinha, Emilie Thibaudeau, and Frederic Dumont have no conflicts of interest to declare.

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Taibi, A., Sgarbura, O., Hübner, M. et al. Feasibility and Safety of Oxaliplatin-Based Pressurized Intraperitoneal Aerosol Chemotherapy With or Without Intraoperative Intravenous 5-Fluorouracil and Leucovorin for Colorectal Peritoneal Metastases: A Multicenter Comparative Cohort Study. Ann Surg Oncol 29, 5243–5251 (2022). https://doi.org/10.1245/s10434-022-11577-2

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