Patients
dysphagia, ascites, nausea, tumor, nausea/vomiting, fatigue, abdominal pain, emesis, CRS, pain, obstipation, NRS, Cancer
DYSPHAGIA, ASCITES, TUMOR, METASTASIS, APPETITE LOSS, OBSTIPATION, METASTASES, CANCER
Before undergoing their first PIPAC procedure, our local multidisciplinary tumor board discussed all patients, namely their PCI (as defined by a most recent and standardized diagnostic laparoscopy in our clinic), comorbidities, and preferences. A curative approach involving sCHT, CRS, and HIPEC was initially ruled out.Inclusion criteria were histologically proven PSM and our multidisciplinary tumor board’s positive recommendation. Exclusion criteria were extraperitoneal distant metastases, and an European Organization for Research and Treatment (ECOG) performance status higher than 2. Deviating from the standard PIPAC inclusion criteria, we treated eleven patients with distant metastases. Three patients with pleural metastases underwent simultaneous pressurized intrathoracic aerosol chemotherapy (PITAC). The remaining distant metastases had been stable or regressive under sCHT, but the peritoneal metastasis (PM) was progressing and causing a severe ascites burden. We decided to attempt PIPAC in these particular cases.Before each scheduled PIPAC procedure, we questioned patients about symptoms associated with PSMs, i.e., abdominal pain, nausea or emesis, dysphagia, and obstipation according to our structured interviews. We evaluated their Nutritional Risk Score (NRS), American Society of Anesthesiologists (ASA) classification, ECOG performance status, and quality of life using the Quality of Life Questionnaire Core 30 (QLQ-C30) by the European Organization for Research and Treatment of Cancer (EORTC). The latter is divided into 15 items including global health (QL2), physical functioning, fatigue, nausea/vomiting, pain, and appetite loss. The individual scores are linearly converted to a 0–100 scale (Aaronson et al. According to our standardized PIPAC perioperative protocol, on the day of admission, as well as on the first and third postoperative days, we measured serum creatinine (µmol/L), and C-reactive protein (mg/L) (COBAS C-system 8000 and E-module; Roche Diagnostics, Mannheim, Germany), as well as leucocytes (10All patients were thoroughly informed by an experienced surgeon and a medical oncologist about the PIPAC procedure and gave their written informed consent.The study was conducted from December 2015 to June 2020 and registered under clinicaltrials.gov (NCT03100708), carried out in accordance with the Declaration of Helsinki, and approved by our local University of Leipzig ethics committee (No. of the approval: 106-16-14032016).