Department of Surgical Oncology, Montpellier Cancer Institute, University of Montpellier, France.
Department of Clinical and Epidemiological Research, Department of Public Health, Lyon Sud University Hospital, EA, 3738, Lyon 1 University, Lyon, France.
Eur J Surg Oncol. 2021 Jan;47(1):149-156. doi: 10.1016/j.ejso.2020.08.020. Epub 2020 Aug 29.
PIPAC is a new treatment modality for peritoneal cancer which has been practiced and evaluated until very recently by few academic centers in a highly standardized manner. Encouraging oncological outcomes and the safety profile have led to widespread adoption. The aim of this study was to assess current PIPAC practice in terms of technique, treatment and safety protocol, and indications.
A standardized survey with 82 closed-ended questions was sent online to active PIPAC centers which were identified by help of PIPAC training centers and the regional distributors of the PIPAC-specific nebulizer. The survey inquired about center demographics (n = 8), technique (n = 34), treatment and safety protocol (n = 34), and indications (n = 6).
Overall, 62 out of 66 contacted PIPAC centers answered the survey (response rate 93%). 27 centers had performed >60 PIPAC procedures. A consensus higher than 70% was reached for 37 items (50%), and higher than 80% for 28 items (37.8%). The topics with the highest degree of consensus were safety and installation issues (93.5% and 80.65%) while chemotherapy and response evaluation were the least consensual topics (63.7 and 59.6%). The attitudes were not influenced by volume, PIPAC starting year, type of activity, or presence of peritoneal metastases program.
Homogeneous treatment standards of new techniques are important to guarantee safe implementation and practice but also to allow comparison between cohorts and multi-center analysis of merged data including registries. Efforts to avoid diversification of PIPAC practice include regular update of the PIPAC training curriculum, targeted research and a consensus statement.
PIPAC 是一种新的腹膜癌治疗方法，直到最近，少数学术中心才以高度标准化的方式进行实践和评估。令人鼓舞的肿瘤学结果和安全性特征导致了广泛的采用。本研究旨在评估当前 PIPAC 治疗的技术、治疗和安全方案以及适应证。
采用标准化的调查问卷，共 82 个封闭式问题，通过 PIPAC 培训中心和 PIPAC 专用雾化器的区域分销商来识别活跃的 PIPAC 中心，然后在线发送该调查问卷。调查询问了中心的人口统计学（n=8）、技术（n=34）、治疗和安全方案（n=34）和适应证（n=6）。
总共联系了 66 个 PIPAC 中心，其中 62 个（响应率为 93%）回答了调查。27 个中心已完成超过 60 次 PIPAC 操作。有 37 个项目（50%）的共识度超过 70%，28 个项目（37.8%）的共识度超过 80%。安全性和安装问题的共识度最高（93.5%和 80.65%），而化疗和反应评估是最不一致的主题（63.7%和 59.6%）。态度不受工作量、PIPAC 起始年份、活动类型或腹膜转移计划的影响。
新疗法的同质化治疗标准对于确保安全实施和实践至关重要，但也允许对队列进行比较，并对包括注册处在内的合并数据进行多中心分析。避免 PIPAC 实践多样化的努力包括定期更新 PIPAC 培训课程、有针对性的研究和共识声明。
