Society for Surgery of the Alimentary Tract

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DISEASE RESPONSE AND SCLEROTIC LOSS OF DOMAIN AFTER 8 PIPAC (PRESSURIZED INTRA-PERITONEAL AEROSOL CHEMOTHERAPY) TREATMENTS: A CASE REPORT.
Katherine Portelli1, Neil Mitra*1, Pablo Palacios1, Danielle K. DePeralta2, Thanh Dellinger3, Mustafa Raoof3, Amit Merchea4, Richard L. Whelan1
1Surgery, Lenox Hill Hospital/ Northwell Health, New York, NY; 2Long Island Jewish Medical Center, New Hyde Park, NY; 3City of Hope Inc, Duarte, CA; 4Mayo Clinic in Florida, Jacksonville, FL

A 63-year-old male with peritoneal metastases from appendiceal cancer underwent 8 PIPAC treatments in a US Phase 1 trial. Results initially showed reduced CEA levels and tumor size. However, repeated PIPAC sessions caused severe peritoneal sclerosis and scarring, affecting visibility and access during successive procedures, limiting further treatment. Although tumor lesions decreased in size and number, there was no clear Peritoneal Regression Grading Score (PRGS) response, suggesting a need to evaluate the long-term balance between PIPAC efficacy and adverse effects.
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