Effect of pressurised intraperitoneal aerosol chemotherapy on the survival rate of patients with peritoneal carcinomatosis of gastric origin

Abstract INTRODUCTION: Pressurised intraperitoneal aerosol chemotherapy (PIPAC) is a new surgical technique, developed for the treatment of initially unresectable peritoneal carcinomatosis (PC). The objective of this study 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 WHO performance status < 3. METHODS: This was a retrospective, single centre, comparative and non-randomised 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: 98 patients were screened and 46 were included (PIPAC_CHEM, n = 17; ONLY_CHEM, n = 29). The 6-month survival rate 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. The median total hospital stay at 6 months was significantly shorter for PIPAC_CHEM (median 2 days [2–7]) vs (median 11 days [3–21]) (p = 0.045). Over the entire follow-up, the median survival [95% CI] in PIPAC_CHEM was 12.8 months [7.2–34.3] vs 9.1 months [5.4–11.5] for the ONLY_CHEM group; p = 0.056. 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. The total hospital stay at 6 months was significantly shorter in the PIPAC_CHEM group.