Symptom Palliation by PIPAC for Peritoneal Carcinomatosis from the Gastrointestinal Tract

Frédéric Dumont1*, Jean-Luc Raoul2, Marie-Françoise Heymann3, Judith Raimbourg2, François-Xavier Piloquet4, Cecile Loaec1, Charlotte Bourgin1, Sandrine Hiret2, Hélène Senellart2, Olivier Kerdraon3 and Emilie Thibaudeau1

1Department of Surgical Oncology, Comprehensive Cancer Center, West Cancer Institute, France
2Department of Medical Oncology, Comprehensive Cancer Center, West Cancer Institute, France
3Department of Pathology, Comprehensive Cancer Center, West Cancer Institute, France
4Department of Palliative and Supportive Care, Comprehensive Cancer Center, West Cancer Institute, France

^*Correspondance to: Frédéric Dumont 

 PDF  Full Text DOI: 10.25107/2474-1647.3430

Abstract

Background: PIPAC is an innovative palliative care treatment for Peritoneal Carcinomatosis (PC). The purpose of this study is to assess the impact of PIPAC with oxaliplatin on symptoms (occlusion, ascites) of peritoneal metastasis from gastrointestinal tract cancer with assessment of early markers of tumor response. Methods: All consecutive PIPAC with oxaliplatin per formed in a comprehensive cancer center between 2017 to 2020 were included. Cox analysis was used to identify time to Worsening of Symptoms (TWS) factors. Results: 25 patients underwent 85 PIPAC (Median period: 105 days). The primary was colorectal, gastric, and small bowel cancer in respectively 13, 10, and 2 cases. The median TWS and Overall Survivals (OS) after the first PIPAC were respectively 207 and 309 days. No early markers of tumor response (lower PCI or histological grading during PIPAC) were associated with TWS. In univariate analysis, TWS factors were extended PC (PCI>20, p=0.03) and presence of symptoms at first PIPAC (p=0.03). In multivariate analysis, these factors did not reach significance. TWS was particularly short (<3 months) for patients with obstructions. Conclusion: PIPAC with oxaliplatin provides prolonged control of carcinomatosis-related symptoms but seems poorly effective to control pre-existing PC obstructions. No predictive factors extending TWS were identified.

Keywords

Peritoneal carcinomatosis; PIPAC; Oxaliplatin; Symptom; Obstruction; Palliative care

Cite the article

Dumont F, Raoul J-L, Heymann M-F, Raimbourg J, Piloquet F-X, Loaec C, et al. Symptom Palliation by PIPAC for Peritoneal Carcinomatosis from the Gastrointestinal Tract. Clin Surg. 2022; 7: 3430..