{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:42:03Z","timestamp":1783575723433,"version":"3.55.0"},"reference-count":25,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,5,8]],"date-time":"2020-05-08T00:00:00Z","timestamp":1588896000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Odense Pancreas Center"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2020,4,16]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Peritoneal metastasis from pancreatic cancer (PM-PC) may be treated with repeated pressurised intraperitoneal aerosol chemotherapy (PIPAC). Utility of next-generation sequencing (NGS) to detect cancer-related mutations in peritoneal quadrant biopsies (QBs) and peritoneal fluid (PF) after systemic and PIPAC treatment has not been evaluated. Around 90% of pancreatic cancers (PCs) harbour a\n                      <jats:italic>KRAS<\/jats:italic>\n                      mutation, making PC ideal for the evaluation of this aspect.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Evaluation of PM-PC in terms of (1) histological response to PIPAC using Peritoneal Regression Grading Score (PRGS), (2) clinical characteristics and (3) frequency of mutations in QBs and PF before and after PIPAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Peritoneal QBs and PF were obtained prior to each PIPAC. NGS for 22 cancer-related genes was performed on primary tumours, QBs and PFs. Response was assessed by the four-tiered PRGS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixteen patients treated with a median of three PIPAC procedures were included. The mean PRGS was reduced from 1.91 to 1.58 (p=0.02). Fifty-seven specimens (13 primary tumours, 2 metastatic lymph nodes, 16 PFs and 26 QB sets) were analysed with NGS.\n                      <jats:italic>KRAS<\/jats:italic>\n                      mutation was found in 14\/16 patients (87.50%) and in QBs, primary tumours and PF in 8\/12 (66.67%), 8\/13 (61.53%) and 6\/9 (66.67%). The median overall survival was 9.9 months (SE 1.5, 95%\u2009CI 4.9 to 13.9).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      PIPAC induces histological response in the majority of patients with PM-PC.\n                      <jats:italic>KRAS<\/jats:italic>\n                      mutation can be found in PM-PC after PIPAC at a frequency similar to the primaries. NGS may be used to detect predictive mutations in PM-PC of various origins, also when only post-PIPAC QBs or PFs are available.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jclinpath-2020-206607","type":"journal-article","created":{"date-parts":[[2020,5,8]],"date-time":"2020-05-08T17:15:29Z","timestamp":1588958129000},"page":"19-24","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Next-generation sequencing and histological response assessment in peritoneal metastasis from pancreatic cancer treated with PIPAC"],"prefix":"10.1136","volume":"74","author":[{"given":"Malene","family":"Nielsen","sequence":"first","affiliation":[{"name":"Department of Pathology, Odense Pancreas Center (OPAC) and Odense PIPAC Center (OPC), Odense University Hospital, Odense, Denmark"},{"name":"Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5719-4916","authenticated-orcid":false,"given":"Martin","family":"Graversen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Odense Pancreas Center (OPAC) and Odense PIPAC Center (OPC), Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Signe Bremholm","family":"Elleb\u00e6k","sequence":"additional","affiliation":[{"name":"Department of Surgery, Odense Pancreas Center (OPAC) and Odense PIPAC Center (OPC), Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Kielsgaard","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Odense Pancreas Center (OPAC) and Odense PIPAC Center (OPC), Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Fristrup","sequence":"additional","affiliation":[{"name":"Department of Surgery, Odense Pancreas Center (OPAC) and Odense PIPAC Center (OPC), Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Pfeiffer","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark"},{"name":"Department of Oncology, Odense Pancreas Center (OPAC) and Odense PIPAC Center (OPC), Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Bau","family":"Mortensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark"},{"name":"Department of Surgery, Odense Pancreas Center (OPAC) and Odense PIPAC 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