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Effect of Pressurized Intraperitoneal Aerosol Chemotherapy on the Survival Rate of Patients with Peritoneal Carcinomatosis of Gastric Origin

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Abstract

Introduction

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new surgical technique for the treatment of initially unresectable peritoneal carcinomatosis (PC). Our objective was to compare the results of PIPAC associated with systemic chemotherapy (PIPAC_CHEM) with those of systemic chemotherapy alone (ONLY_CHEM) in patients with gastric PC without metastasis other than peritoneal, and the WHO performance status < 3.

Methods

This was a retrospective, single center, comparative non-randomized study. Seventeen PIPAC_CHEM patients were compared to 29 ONLY_CHEM patients. The primary endpoint was overall survival at 6 months from diagnosis of PC.

Results

Ninety-eight patients were screened and 46 were included (PIPAC_CHEM, n = 17; ONLY_CHEM, n = 29). The PIPAC_ CHEM population was significantly younger (median 64 years [56; 68] vs 74 years [61; 79]; p = 0.0054). Median PIPAC session per patient is 2 [1–3]. Six-month survival was significantly higher in the PIPAC_CHEM group than in the ONLY_CHEM group 16/17 (94.1% [65–99.2]) vs 19/29 (65.5% [45.4–79.7]), respectively; p = 0.029. Over the entire follow-up, median survival [95% CI] was 12.8 months [7.2–34.3] with PIPAC vs 9.1 months [5.4–11.5] without, p = 0.056.

At 6 months, median length of additional hospitalization was significantly less for PIPAC_CHEM (median 2 days [2–7]) than without PIPAC (median 11 days [3–21]) (p = 0.045).

Conclusion

The overall survival at 6 months after the diagnosis of carcinomatosis was significantly better for PIPAC_CHEM patients. This difference appears to continue until at least 18 months. At 6 months, days of additional hospitalization was significantly less in the PIPAC_CHEM group.

Trial Registration

Clinicaltrials.gov Identifier: NCT 04,879,953

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Availability of Data and Material (Data Transparency)

Anonymized patient data will be made available on reasonable request for academic use after publication of the article and with a signed contract between the applicant and Grenoble Alpes University Hospital.

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Authors and Affiliations

  1. Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, Grenoble, France

    Fatah Tidadini, Julio Abba, Magalie Baudrant, Aline Bonne, Jean-Luc Faucheron & Catherine Arvieux

  2. Lyon Center for lnnovation in Cancer- EA 3738, Lyon 1 University, Lyon, EA, France

    Fatah Tidadini, Olivier Glehen, Laurent Villeneuve & Catherine Arvieux

  3. Clinical Pharmacology Unit, INSERM CIC1406, Grenoble Alpes University Hospital, Grenoble, France

    Jean-Louis Quesada & Alison Foote

Authors
  1. Fatah Tidadini
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  2. Julio Abba
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  3. Jean-Louis Quesada
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  4. Magalie Baudrant
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  5. Aline Bonne
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  6. Alison Foote
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  7. Jean-Luc Faucheron
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  8. Olivier Glehen
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  9. Laurent Villeneuve
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  10. Catherine Arvieux
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Contributions

Study concept and design: Tidadini, Glehen, Villeneuve, and Arvieux. Data acquisition: Tidadini, Abba, and Arvieux. Quality control of data and algorithms: Tidadini, Abba, Bonne, Baudrant, and Arvieux. Data analysis and interpretation: Tidadini, Abba, Quesada, Faucheron, Foote, and Arvieux. Statistical analysis: Quesada. Manuscript editing: Tidadini, Foote, Bonne, and Arvieux. Manuscript review: all authors.

Corresponding author

Correspondence to Catherine Arvieux.

Ethics declarations

Ethics Approval

Study ethical approval was obtained on 03.02.2021 (CECIC Rhône-Alpes-Auvergne, Clermont-Ferrand, IRB 5891) and was registered in the CHU Grenoble Alpes register of studies respecting the reference methodology MR004 of the National Commission for Informatics and Liberties (CNIL).

Informed Consent

Patients were informed that their anonymized data might in the future be the subject of a research protocol and could oppose this by informing the doctor.

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Not applicable.

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The authors declare no competing interests.

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Tidadini, F., Abba, J., Quesada, JL. et al. Effect of Pressurized Intraperitoneal Aerosol Chemotherapy on the Survival Rate of Patients with Peritoneal Carcinomatosis of Gastric Origin. J Gastrointest Canc 53, 971–979 (2022). https://doi.org/10.1007/s12029-021-00698-8

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  • DOI: https://doi.org/10.1007/s12029-021-00698-8

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