Preventive Use of Pressurized Intraperitoneal Aerosol Chemotherapy PIPAC Combined with Chemotherapy and Surgery in Adults with Locally Advanced Gastric Cancer

What this Trial Is About

Gastric cancer is a common and serious disease, ranking as the fifth most frequent cancer worldwide and the third leading cause of cancer-related deaths. Patients with locally advanced gastric cancer often face the challenge of peritoneal carcinomatosis PC, a condition occurring in 60% of cases after surgery and linked to poor outcomes. Researchers are evaluating whether adding a new preoperative treatment called pressurized intraperitoneal aerosolized chemotherapy PIPAC can reduce the occurrence of PC compared to standard treatment alone. The study compares two groups one receiving PIPAC with the chemotherapy drugs cisplatin and doxorubicin before standard perioperative chemotherapy FLOT regimen and surgery including gastrectomy with lymphadenectomy the other group is a retrospective cohort receiving only the standard chemotherapy and surgery. PIPAC delivers chemotherapy as an aerosol directly to the peritoneal surface, aiming to penetrate tumor implants more deeply while minimizing side effects. Participants will be monitored through scheduled assessments, including evaluations of survival rates, disease progression, quality of life using the EORTC QLQ-C30 questionnaire, and safety events. The main outcome is the incidence of peritoneal carcinomatosis at 12 and 24 months after surgery. Secondary outcomes include overall and disease-free survival, adverse events, and pathological response. The study begins in January 2025 and will follow participants over multiple years to gather these results.

Preventive Use of PIPAC in Locally Advanced Gastric Cancer.