Pleura and Peritoneum最新文献

{"title":"Pressurised intraperitoneal aerosol chemotherapy (PIPAC): the first Australian experience.","authors":"Katarina Foley, Jessica Reid, Suzanne Edwards, Timothy Price, Allan Zimet, Susan Woods, Markus Trochsler, Andrew Craig Lynch, Peter Hewett","doi":"10.1515/pp-2024-0028","DOIUrl":"https://doi.org/10.1515/pp-2024-0028","url":null,"abstract":"<p><strong>Objectives: </strong>Pressurised intraperitoneal aerosol chemotherapy (PIPAC) is a novel surgical technique for patients with peritoneal metastases not amenable to curative treatment. PIPAC delivers pressurised aerosolised chemotherapy using a hyperbaric capnoperitonem established laparoscopically. This study sought to investigate the feasibility and safety of PIPAC in an Australian population.</p><p><strong>Methods: </strong>We undertook a cohort analysis of prospectively-collected data on patients undergoing PIPAC across two Australian hospitals. Participants were planned to have three PIPAC procedures, each 6 weeks apart. Study outcomes included post-operative complications including 30-day mortality, length of stay (LOS) and patient quality of life (EORTC QLQ-C30 scores).</p><p><strong>Results: </strong>18 patients underwent 50 completed procedures. 13 patients had two or more PIPACs. The most common primary malignancy was colorectal cancer (n=8), followed by gastric cancer (n=4), appendiceal cancer (n=4) and mesothelioma (n=2). One grade four but no grade five complications occurred, with zero 30-day mortality. Median LOS was 1 day. Mean EORTC QLQ-C30 score increased from 47.8 at baseline to 53 post second PIPAC. Due to the heterogeneity of our cohort, survival analysis and statistical comparisons were unable to be made.</p><p><strong>Conclusion: </strong>PIPAC is feasible, safe and well tolerated in an Australian population with a lack of severe complications and zero 30 day mortality. Due to the small number of patients and the heterogeneity of our study's sample, it was not possible to perform survival analysis. The study is nonetheless valuable as the first investigation of implementation of PIPAC in Australia.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"10 1","pages":"25-31"},"PeriodicalIF":1.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can inter-observer consistency be achieved in the laparoscopic assessment of the peritoneal carcinomatosis index score in peritoneal metastasis? A pilot study.","authors":"Audrey Astruc, Valérie Seegers, Frederic Dumont, Cécile Loaec, Emilie Thibaudeau, Charlotte Bourgin, Romuald Wernert, Noémie Body, Valeria De Franco","doi":"10.1515/pp-2024-0015","DOIUrl":"https://doi.org/10.1515/pp-2024-0015","url":null,"abstract":"<p><strong>Objectives: </strong>The main prognostic factor for peritoneal metastasis (PM) is the complete resection of the disease during cytoreductive surgery. Accurate patient selection is therefore essential for determining eligibility for this type of surgery. The peritoneal carcinomatosis index (PCI) is a widely used tool for assessing the extent of carcinomatosis. This study aimed to evaluate the inter-observer reproducibility of PCI assessments via laparoscopy and identify factors influencing this reproducibility.</p><p><strong>Methods: </strong>Between November 2020 and November 2022, 25 laparoscopic PCI assessment videos were reviewed by six surgeons from two centers. The total PCI score, regional PCI scores, and the number of visualized PCI areas were recorded. Inter-observer concordance was analyzed.</p><p><strong>Results: </strong>The median PCI score was 12 out of 39 (range 0-39), and the median number of visualized PCI regions was 10 out of 13 (range 1-13). The intraclass correlation coefficient (ICC) for the total PCI score was 0.846 (95 % CI 0.738, 0.927). A history of abdominal surgery significantly impacted PCI assessment reproducibility (p=0.029).</p><p><strong>Conclusions: </strong>This study found a high inter-observer concordance in laparoscopic PCI assessments. Previous abdominal surgery negatively affected reproducibility, highlighting a challenge in evaluating the PCI in these patients.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"10 1","pages":"19-23"},"PeriodicalIF":1.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneal melanomatosis due to primary anorectal melanoma.","authors":"Aras Emre Canda, Semra Demirli Atici, Evren Kadioglu, Cem Terzi","doi":"10.1515/pp-2025-0002","DOIUrl":"https://doi.org/10.1515/pp-2025-0002","url":null,"abstract":"","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"10 1","pages":"33-34"},"PeriodicalIF":1.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging gastric cancer metastasis progression in an organotypic, three-dimensional functional model of the human peritoneum.","authors":"Arianna Castagna, Frank-Jürgen Weinreich, Andreas Brandl, Janine Spreuer, Nicola Herold, Birgit Schittek, Marc André Reymond, Wiebke Solass","doi":"10.1515/pp-2024-0020","DOIUrl":"https://doi.org/10.1515/pp-2024-0020","url":null,"abstract":"<p><strong>Objectives: </strong>Despite the introduction of multimodal treatment regimens, the prognosis of gastric cancer peritoneal metastasis (GCPM) remains poor. To establish efficient therapies, a deeper understanding of pathophysiological mechanisms in the development of GCPM is necessary and this requires adequate functional models. Therefore, we established a three-dimensional model to study tumor adhesion, invasion and growth.</p><p><strong>Methods: </strong>A co-culture of peritoneal mesothelial cells with fibroblasts and collagen I was cultivated to further seed human gastric cancer cell lines on the surface. Different imaging techniques (optical microscopy, immunohistochemistry, scanning (SEM) and transmission (TEM) electron microscopy) served as tools to proof the sustainability of the model.</p><p><strong>Results: </strong>We demonstrated the feasibility of creating a robust GCPM model. We showed that the model is reproducible under various conditions (6-, 12-, and 24-wells) and pre-analytical processing is possible. The imaging was feasible and allowed the comparison of morphological changes on the GCPM model to normal human peritoneum.</p><p><strong>Conclusions: </strong>We established a reproducible and robust organotypic model of GCPM which can be used to generate deeper knowledge on the pathophysiology of GCPM and might serve as a platform for testing different chemotherapy schemes in order to establish a personalized treatment for patients with GCPM.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"10 1","pages":"11-17"},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-specific 3D-tissue slices from peritoneal metastases - An <i>in vitro</i> model for individual susceptibility analysis.","authors":"Christian Etzold, Orestis Lyros, Matthias Mehdorn, Robert Nowotny, Stefan Niebisch, Boris Jansen-Winkeln, Katrin Schierle, Ines Gockel, René Thieme","doi":"10.1515/pp-2024-0012","DOIUrl":"https://doi.org/10.1515/pp-2024-0012","url":null,"abstract":"<p><strong>Objectives: </strong>The prognosis of patients with peritoneal metastases (PM) is poor, and these patients have a brief overall survival. Most patients with advanced PM receive palliative therapy to maintain their quality of life. In our current study, we investigated whether patient-specific 3D-tissue slices from patients with PM subjected to pressurized intraperitoneal aerosol chemotherapy could be cultured <i>in vitro</i>.</p><p><strong>Methods: </strong>Biopsies from gastric cancer patients with PM were characterized for cytokeratin-positive tumor cells and the proliferation marker Ki-67. Biopsies from seven patients were cut to 350 µM thick slices in a standardized manner, cultured with 10 µM 5-fluorouracil, doxorubicin, cisplatin, oxaliplatin, or irinotecan for 96 h, and then examined histopathologically and via immunohistochemistry for persistent cytokeratin and Ki-67 expression.</p><p><strong>Results: </strong><i>In vitro</i> cultured slices revealed a similar morphology to un-cultured specimens, and Ki-67-positive tumor cell areas were present after 96 h. The total amount of tumor cells per slice was determined by pan-cytokeratin staining. In the doxorubicin-treated slices, the cytokeratin-positive tumor cell fraction and proliferative (Ki-67pos) cells were decreased. Patient-specific 3D-tissue-slice cultures from peritoneal biopsies were cultured <i>in vitro</i> for up to 4 days.</p><p><strong>Conclusions: </strong>Potentially, these cultures are a reliable model to evaluate the chemosensitivity of patients with PM. Further investigation is needed to match the chemosensitivity with the clinical course of these patients.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"10 1","pages":"1-9"},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"14^th PSOGI-ISSPP International congress on Peritoneal Surface Malignancies*: Lyon, 26 - 28^TH September 2024.","authors":"","doi":"10.1515/pp-2024-0031","DOIUrl":"https://doi.org/10.1515/pp-2024-0031","url":null,"abstract":"","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"9 Suppl1","pages":"A1-A199"},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: Questioning the role of HIPEC in patients with granulosa cell ovarian tumours.","authors":"Luis Felipe Falla-Zuniga, Armando Sardi, Mary Caitlin King, Vadim Gushchin","doi":"10.1515/pp-2024-0025","DOIUrl":"10.1515/pp-2024-0025","url":null,"abstract":"","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"9 4","pages":"157-158"},"PeriodicalIF":1.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questioning the role of HIPEC in patients with granulosa cell ovarian tumours.","authors":"Christos Iavazzo, Ioannis D Gkegkes","doi":"10.1515/pp-2024-0002","DOIUrl":"10.1515/pp-2024-0002","url":null,"abstract":"","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"9 4","pages":"155"},"PeriodicalIF":1.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and evaluation of Pressurized IntraThoracic Aerosol Chemotherapy (PITAC) for the treatment of patients with malignant pleural effusion: study protocol for the Danish phase-I PITAC-OPC5 study.","authors":"Pernille Schjødt Hansen, Martin Graversen, Sönke Detlefsen, Alan Patrick Ainsworth, Claus Wilki Fristrup, Lise Eckhoff, Mia Jelin-Klaric, Michael Bau Mortensen","doi":"10.1515/pp-2024-0014","DOIUrl":"10.1515/pp-2024-0014","url":null,"abstract":"<p><strong>Objectives: </strong>Pressurized IntraThoracic Aerosol Chemotherapy (PITAC) is a minimally invasive cancer-directed therapy for patients with malignant pleural effusion (MPE) and/or pleural metastasis (PLM). PITAC is based on Pressurized IntraPeritoneal Aerosol Chemotherapy, which has proven to be safe and feasible. Since 2012, 47 PITACs have been published, and prospective data on feasibility, safety and potential local response are lacking.</p><p><strong>Methods: </strong>The prospective, controlled, phase-I study is designed to treat MPE with PITAC. There are no data to support the estimated number of patients needed, but previous experience estimates the non-access rate to 20 %. Twenty eligible patients with MPE will receive two or more PITACs at four-week intervals. During video-assisted thoracoscopy, MPE and/or pleural lavage fluid is evacuated, and the extent of visible PLM is assessed. Pleural biopsies are collected, if possible, for histological response as per Thoracic Regression Grading Score (TRGS). Patients are screened for treatment-related intra- and postoperative complications. The primary outcome is the number of patients with Clavien-Dindo ≥3b or Common Terminology Criteria for Adverse Events≥4 within 30 days. Secondary objectives include PLM-score, TRGS and cytology, length of hospitalization, personnel safety, quality of life, and change in MPE volume.</p><p><strong>Results: </strong>PITAC is expected to be safe and feasible for patients and personnel, and achieve positive results in the reduction of MPE volume.</p><p><strong>Conclusions: </strong>The results may significantly impact the next clinical, technical, and scientific steps in the implementation of PITAC. Given the suboptimal treatment options for MPE and the seemingly promising results of PITAC, we find the implementation of PITAC ethically reasonable and sound.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"9 4","pages":"141-148"},"PeriodicalIF":1.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressurized IntraThoracic Aerosol Chemotherapy (PITAC) directed therapy of patients with malignant pleural effusion and pleural metastasis.","authors":"Pernille Schjødt Hansen, Martin Graversen, Sönke Detlefsen, Alan Patrick Ainsworth, Michael Bau Mortensen","doi":"10.1515/pp-2024-0008","DOIUrl":"10.1515/pp-2024-0008","url":null,"abstract":"<p><strong>Objectives: </strong>Pressurized IntraThoracic Aerosol Chemotherapy (PITAC) has been suggested as a new therapy for patients with malignant pleural effusion (MPE) and/or pleural metastasis (PLM). The patients have a poor prognosis with a median survival of 3 to 12 months. We present feasibility, patient safety, and cytological/histological response assessment in PITAC-treated patients with MPE and/or PLM.</p><p><strong>Methods: </strong>Patients eligible for PITAC and treated at Odense PIPAC Center were included. PITAC was performed in lateral decubitus or prone position under double-lumen endotracheal tube ventilation to allow exclusion of the lung if necessary. After positioning of the ultrasound-guided trocar, the second trocar is inserted by video-assisted thoracoscopy. MPE was evacuated and measured. Pleural lavage was performed if no or small amounts of MPE were present. MPE or pleural lavage fluid was analyzed cytologically. Visible PLM was biopsied and sent for histology assessment using a four-tiered Thoracic Regression Grading Score (TRGS). After a walkthrough of the safety checklist, the chemotherapy was nebulized followed by 30 min of passive diffusion. The chemotherapy and chemotherapy-saturated air was evacuated through a closed bag and ventilation system.</p><p><strong>Results: </strong>We report data on 11 intended PITACs in five patients. Nine PITACs were completed and two PITACs were discontinued due to intraoperative complications or technical reasons. Response evaluation was available in three patients: one showed complete response (TRGS 1) and another stable disease (TRGS 2). Cytology was available from two patients: one showed conversion from malignant to benign. The 30-day mortality was zero.</p><p><strong>Conclusions: </strong>PITAC appears to be safe and feasible.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"9 4","pages":"131-139"},"PeriodicalIF":1.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}