Evidence map›Paper›PMID 37270440›Full record

ArticleAnnals of surgical oncology2023

Bidirectional Approach with PIPAC and Systemic Chemotherapy for Patients with Synchronous Gastric Cancer Peritoneal Metastases (GCPM).

Francesco Casella, Maria Bencivenga, Giorgio Brancato, Lorena Torroni, Cecilia Ridolfi, Carmelo Puccio, Mariella Alloggio, Francesca Meloni, Daniele Fusario, Daniele Marrelli and 3 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
7.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Pressurised intraperitoneal aerosol chemotherapy (PIPAC) for peritoneal metastases: a scoping review of clinical evidence across emerging indications.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

Francesco CasellaUpper G.I. Surgery Division, University of Verona, Verona, Italy.
Maria BencivengaUpper G.I. Surgery Division, University of Verona, Verona, Italy. maria.bencivenga@univr.it.
Giorgio BrancatoUpper G.I. Surgery Division, University of Verona, Verona, Italy.
Lorena TorroniDepartment of Diagnostics and Public Health, Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy.
Cecilia RidolfiUpper G.I. Surgery Division, University of Verona, Verona, Italy.
Carmelo PuccioUpper G.I. Surgery Division, University of Verona, Verona, Italy.
Mariella AlloggioUpper G.I. Surgery Division, University of Verona, Verona, Italy.
Francesca MeloniUpper G.I. Surgery Division, University of Verona, Verona, Italy.
Daniele FusarioDepartment of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy.
Daniele MarrelliDepartment of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy.
Simone GiacopuzziUpper G.I. Surgery Division, University of Verona, Verona, Italy.
Franco RovielloDepartment of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy.
Giovanni de ManzoniUpper G.I. Surgery Division, University of Verona, Verona, Italy.
University of Verona · ITUniversity of Siena · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study evaluated the efficacy of pressurized intraperitoneal aerosol chemotherapy (PIPAC) with systemic chemotherapy as a bidirectional approach for gastric cancer (GC) patients with synchronous peritoneal metastases (SPM).

methodsA retrospective analysis of a prospective PIPAC database was queried for patients who underwent a bidirectional approach between October 2019 and April 2022 at two high-volume GC surgery units in Italy (Verona and Siena). Surgical and oncological outcomes were analyzed.

resultsBetween October 2019 and April 2022, 74 PIPAC procedures in 42 consecutive patients with Eastern Cooperative Oncology Group performance status ≤2 were performed-32 patients treated in Verona and 10 in Siena. Twenty-seven patients (64%) were female and median age at first PIPAC was 60.5 years (I-III quartiles: 49-68 years). Median Peritoneal Cancer Index (PCI) was 16 (I-III quartiles: 8-26) and 25 patients (59%) had at least two PIPAC procedures. Major complications according to the Common Terminology Criteria for Adverse Events (CTCAE; 3 and 4) occurred in three (4%) procedures, and, according to the Clavien-Dindo classification (>3a), one (1%) severe complication occurred. There were no reoperations or deaths within 30 days. Median overall survival (mOS) from diagnosis was 19.6 months (range 14-24), and mOS from first PIPAC was 10.5 months (range 7-13). Excluding cases with very heavy metastatic peritoneal burden, with PCI from 2 to 26, treated with more than one PIPAC, mOS from diagnosis was 22 months (range 14-39). Eleven patients (26%) underwent curative-intent surgery after a bidirectional approach. R0 was achieved in nine (82%) patients and complete pathological response was obtained in three (27%) cases.

conclusionsPatient selection is associated with bidirectional approach efficacy and feasibility for SPM GC treatment, which may allow potentially curative surgical radicalization in highly selected cases.

Indexed as

Peritoneal NeoplasmsStomach NeoplasmsAerosolsCisplatinDoxorubicinFemaleHumansMaleMiddle AgedProspective StudiesRetrospective StudiesAerosolsCisplatinDoxorubicinBidirectionalGastric cancerPeritoneal metastasesPIPAC

Identifiers

PMID37270440
PMCPMC10409663
OpenAlexW4379193298

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.