Thomas A Falkenstein1, Thorsten O Götze2, Mehdi Ouaissi3, Clemens B Tempfer4,5, Urs Giger-Pabst6,5, Cédric Demtröder5. 1. Basic Research Laboratories of the Department of Surgery, St. Mary's Hospital, Ruhr University Bochum, Herne, Germany. 2. Institute of Clinical Cancer Research, UCT-University Cancer Center Frankfurt, Hospital Nordwest, Frankfurt, Germany. 3. Department of Digestive, Oncology, Endocrine and Liver Transplantation, Colorectal Surgery Unit, Trousseau Hospital, Tours, France. 4. Department of Obstetrics and Gynecology, St. Mary's Hospital, Ruhr University Bochum, Herne, Germany. 5. General Surgery and Therapy Center for Peritoneal Carcinomatosis, St. Mary's Hospital, Ruhr University Bochum, Herne, Germany. 6. Basic Research Laboratories of the Department of Surgery, St. Mary's Hospital, Ruhr University Bochum, Herne, Germany urs.pabst@elisabethgruppe.de.
Abstract
BACKGROUND: Patients suffering from peritoneal metastasis of biliary tract cancer were treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC). PATIENTS AND METHODS: This was a study carried out at a single institution, tertiary referral center certified for therapy of peritoneal disease. Retrospective data analysis was performed of prospective data for PIPAC with intra-peritoneal low-dose doxorubicin (1.5 mg/m2) and cisplatin (7.5 mg/m2) delivered at intervals of 6 weeks. The outcome criteria were microscopic pathological response, survival, and adverse events [Common Terminology Criteria of Adverse Events (v4.0)]. RESULTS: A total of 13 patients (male/female=8/5) with a mean age of 58 (range=37-75) years underwent 17 PIPAC procedures without intraoperative complications. The mean number of PIPAC applications was 1.3 (range=0-3). Due to non-accessibility of the abdominal cavity in two patients (15.4%) and rapid clinical deterioration in six patients (46%), five patients underwent two or more PIPAC applications and were, therefore, eligible for histological analysis to assess carcinoma regression. Overall tumor regression of any degree was determined in 4/5 patients. An overall median survival of 85 days (95% confidence interval(CI)=59.2-110.4 days) after the first PIPAC application was observed. No complications greater than Common Terminology Criteria of Adverse Events (v4.0) level 2 occurred. CONCLUSION: PIPAC can induce objective regression of systemic chemotherapy-resistant peritoneal metastasis of biliary tract cancer. However, due to a rapid clinical deterioration of the patients, almost two-thirds of the patients cannot undergo repetitive PIPAC courses. Copyright
BACKGROUND:Patients suffering from peritoneal metastasis of biliary tract cancer were treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC). PATIENTS AND METHODS: This was a study carried out at a single institution, tertiary referral center certified for therapy of peritoneal disease. Retrospective data analysis was performed of prospective data for PIPAC with intra-peritoneal low-dose doxorubicin (1.5 mg/m2) and cisplatin (7.5 mg/m2) delivered at intervals of 6 weeks. The outcome criteria were microscopic pathological response, survival, and adverse events [Common Terminology Criteria of Adverse Events (v4.0)]. RESULTS: A total of 13 patients (male/female=8/5) with a mean age of 58 (range=37-75) years underwent 17 PIPAC procedures without intraoperative complications. The mean number of PIPAC applications was 1.3 (range=0-3). Due to non-accessibility of the abdominal cavity in two patients (15.4%) and rapid clinical deterioration in six patients (46%), five patients underwent two or more PIPAC applications and were, therefore, eligible for histological analysis to assess carcinoma regression. Overall tumor regression of any degree was determined in 4/5 patients. An overall median survival of 85 days (95% confidence interval(CI)=59.2-110.4 days) after the first PIPAC application was observed. No complications greater than Common Terminology Criteria of Adverse Events (v4.0) level 2 occurred. CONCLUSION:PIPAC can induce objective regression of systemic chemotherapy-resistant peritoneal metastasis of biliary tract cancer. However, due to a rapid clinical deterioration of the patients, almost two-thirds of the patients cannot undergo repetitive PIPAC courses. Copyright
Authors: Philipp Horvath; Stefan Beckert; Florian Struller; Alfred Königsrainer; Marc André Reymond Journal: Clin Exp Metastasis Date: 2018-07-30 Impact factor: 5.150
Authors: Florian Kurtz; Florian Struller; Philipp Horvath; Wiebke Solass; Hans Bösmüller; Alfred Königsrainer; Marc A Reymond Journal: Gastroenterol Res Pract Date: 2018-10-24 Impact factor: 2.260
Authors: Thorsten Oliver Goetze; Salah-Eddin Al-Batran; Urs Pabst; Marc Reymond; Clemens Tempfer; Wolf O Bechstein; Ulli Bankstahl; Ines Gockel; Alfred Königsrainer; Thomas Kraus; Stefan P Mönig; Beate Rau; Matthias Schwarzbach; Pompiliu Piso Journal: Pleura Peritoneum Date: 2018-06-08