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REVIEW  UPDATES IN OVARIAN CANCER AND SECONDARY PERITONEAL TUMORS 

Minerva Medica 2019 August;110(4):385-98

DOI: 10.23736/S0026-4806.19.06081-6

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

From palliation to cure: PIPAC for peritoneal malignancies

Andrea DI GIORGIO 1, Carlo ABATINI 1, Miriam ATTALLA EL HALABIEH 1, Emanuele VITA 2, Giuseppe VIZZIELLI 3, Valerio GALLOTTA 3, Fabio PACELLI 1, Stefano ROTOLO 1, 4

1 Division of General Surgery, A. Gemelli University Hospital and Institute for Research and Care, Rome, Italy; 2 Division of Medical Oncology, A. Gemelli University Hospital and Institute for Research and Care, Rome, Italy; 3 Unit of Gynecologic Oncology, A. Gemelli University Hospital and Institute for Research and Care, Rome, Italy; 4 Department of Surgery, Oncology, and Stomatology, University of Palermo, Palermo, Italy



INTRODUCTION: Systemic chemotherapy offers poor control over peritoneal disease, maybe as a consequence of restricted drug availability within the abdominal cavity. Locoregional chemotherapy may overcome these shortcomings but its administration is limited to a few patients with confined peritoneal spread. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) emerged in the last years as a novel method of intraperitoneal drug administration.
EVIDENCE ACQUISITION: We report a meta-analysis of published studies on PIPAC safety and pathological anti-tumoral efficacy on PC from various tumor entities, with the aim of providing more evidence to support further research. This systematic review and meta-analysis were designed, conducted and reported according to the PRISMA statement.
EVIDENCE SYNTHESIS: An overall pathological response rate of 43.7% was calculated on a total of 668 patients who underwent 1480 PIPAC cycles across the 20 studies. Pooled severe adverse events rate (CTCAE grade 3-4) was 10% and seven deaths across all studies were reported, of which only four were related to PIPAC.
CONCLUSIONS: PIPAC is a safe procedure which has a relevant anti-tumoral activity on peritoneal carcinomatosis. Further studies, even in the early stage of disease, are awaited to assess the clinical benefit of PIPAC. This review may serve as a reliable basis for future research.


KEY WORDS: Palliative care; Peritoneal neoplasms; Drug therapy

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