To improve the prognosis and maintain quality of life in patients with peritoneal metastasis (PM), a novel treatment has been introduced-pressurized intraperitoneal aerosol chemotherapy (PIPAC). The majority of teams propose at least 3 PIPAC procedures. However, for many patients PIPAC is stopped after only one or two procedures. The aim of this study was to identify the reasons for stopping PIPAC after only one or two procedures and to establish a profile of poor candidates. This retrospective, multicenter cohort study included all patients who underwent PIPAC in three French expert centers between 2015 and 2021. A total of 268 PIPAC procedures were performed in 89 patients. Of them, 48.3% of patients underwent fewer than three procedures: 28.1% had one, 20.2% two and 51.7% three or more PIPAC procedures. The main reason for stopping PIPAC, regardless of the number of procedures, was disease progression, in 55.8% of cases. Other reasons for stopping PIPAC were non-access to the abdominal cavity (7.9%), conversion to cytoreductive surgery (13.5%), post-PIPAC adverse events (7.9%), patients' wishes (10.1%) and death (2.2%). In univariate analysis, patients who received fewer than three PIPACs less frequently had chemotherapy beforehand (91% vs 100%, p = 0.05), less frequently had bimodal treatment (70% vs 87%, p = 0.04), had more ascites (median 80 ml vs 50 ml, p = 0.05) and more frequently had carcinomatosic ascites (48.8% vs 23.9%, p < 0.01). Performing PIPAC alone in chemotherapy-naïve patients with ascites should be avoided.

中文翻译：

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停止加压腹膜内气溶胶化疗 (PIPAC) 的原因：一项旨在改善未来患者选择的回顾性研究。

为了改善腹膜转移（PM）患者的预后并维持生活质量，引入了一种新的治疗方法——加压腹膜内气雾化疗（PIPAC）。大多数团队提出至少 3 个 PIPAC 程序。然而，对于许多患者来说，PIPAC 仅在一两次手术后就停止了。本研究的目的是确定仅经过一两次手术后停止 PIPAC 的原因，并建立不良候选人的概况。这项回顾性、多中心队列研究包括 2015 年至 2021 年间在三个法国专家中心接受 PIPAC 的所有患者。89 名患者总共进行了 268 次 PIPAC 手术。其中，48.3% 的患者接受过少于 3 次 PIPAC 手术：28.1% 接受过 1 次 PIPAC 手术，20.2% 接受过 2 次，51.7% 接受过 3 次或以上 PIPAC 手术。无论手术次数多少，停止 PIPAC 的主要原因是疾病进展，占 55.8% 的病例。停止 PIPAC 的其他原因包括无法进入腹腔（7.9%）、转为细胞减灭术（13.5%）、PIPAC 术后不良事件（7.9%）、患者意愿（10.1%）和死亡（2.2%） 。在单变量分析中，接受少于 3 个 PIPAC 的患者事先接受化疗的频率较低（91% vs 100%，p = 0.05），接受双模式治疗的频率较低（70% vs 87%，p = 0.04），腹水较多（中位数） 80 ml vs 50 ml，p = 0.05）并且更常见的是癌性腹水（48.8% vs 23.9%，p < 0.01）。应避免对未接受过化疗的腹水患者单独进行 PIPAC。