Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) as an outpatient procedure.

Abstract

BACKGROUND:

Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) is a drug-delivery method for patients with peritoneal metastasis (PM). The study objective was to investigate whether PIPAC is possible in an outpatient setting.

METHODS:

Data was extracted from the prospective PIPAC-OPC2 study (ClinicalTrials.gov NCT03287375). Patients with PM were treated by cisplatin and doxorubicin (PIPAC C/D), except patients with colorectal PM, who were treated by oxaliplatin (PIPAC OX). Patients were evaluated concerning the suitability for carrying out the PIPAC procedure in an out- patient setting. The preconditions for outpatient surgery were that the patient should be (1) freely mobilized, (2) adequately pain-relieved, (3) have untroubled urination and (4) without anxiety or discomfort caused by leaving the hospital.

RESULTS:

During the study period, 106 PIPAC procedures (79 PIPAC C/D, 27 PIPAC OX) were performed in 41 patients with gastrointestinal or ovarian PM. Ninety percent (37/41) of the patients were pretreated with systemic chemotherapy. Eight patients (20%) received bidirectional chemotherapy. Twenty-four percent (10/41) of the first PIPAC procedures were completed in an outpatient setting, which increased to 65% (13/20) in PIPAC no 3 (p=0.008). In the PIPAC C/D cohort, 28% and 80% of the PIPACs were performed in the outpatient setting at PIPAC 1 and 3 respectively, contrasting to only 11% and 20% in the PIPAC OX group. No readmissions after outpatient care. Postoperative morphine administration was more frequent in the PIPAC OX group.

CONCLUSIONS:

The PIPAC procedure can be performed in an outpatient setting. The critical component for success is pain control.

• Authors: Martin Graversen, Lars Lundell, Claus Fristrup, Per Pfeiffer, Michael B Mortensen
• Journal: Pleura and peritoneum (Pleura Peritoneum) Vol. 3 Issue 4 Pg. 20180128 (Dec 01 2018) ISSN: 2364-768X [Electronic] Germany
• PMID: 30911669 (Publication Type: Journal Article)