{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:32:22Z","timestamp":1792103542793,"version":"4.4.0"},"reference-count":18,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T00:00:00Z","timestamp":1654560000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_pp-2022-0111_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Peritoneal carcinomatosis is the most frequent site of metastases in patients with gastric cancer. Current standard treatment is palliative systemic chemotherapy with very poor prognosis. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) resulted in long-term benefits in selected patients. Among patients with peritoneal carcinomatosis, a distinctive subset is oligometastatic disease which is characterized by low metastatic burden. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a recent technique of intraperitoneal chemotherapy used in combination with systemic chemotherapy with promising results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_pp-2022-0111_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PIPAC VER-One is a prospective, randomized, multicenter phase III clinical trial that aims to evaluate the effectiveness of the use of PIPAC in combination with systemic chemotherapy in patients with gastric cancer and synchronous positive peritoneal cytology and\/or limited peritoneal metastases (peritoneal cancer index [PCI]\u00a0\u22646). Patients will be randomized into two arms: arm A (control) treated with standard systemic chemotherapy and arm B (experimental) treated with a bidirectional scheme including PIPAC and systemic chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_pp-2022-0111_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Primary endpoint is the secondary resectability rate. Secondary endpoints are: overall survival (OS), pregression-free survival (PFS), disease-free survival (DFS), histological response assessed both on primary tumor and peritoneal lesions, quality of life (QoL), complication rate (CTCAE v5), and incremental cost-effectiveness ratios (ICER).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_pp-2022-0111_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The role of PIPAC in multimodal treatment for oligometastatic gastric cancer will be investigated in this trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/pp-2022-0111","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T20:46:57Z","timestamp":1654548417000},"page":"135-141","source":"Crossref","is-referenced-by-count":48,"title":["Pressurized intraperitoneal aerosol chemotherapy (PIPAC) in multimodal therapy for patients with oligometastatic peritoneal gastric cancer: a randomized multicenter phase III trial PIPAC VEROne"],"prefix":"10.1515","volume":"7","author":[{"given":"Francesco","family":"Casella","sequence":"first","affiliation":[{"name":"Department and of Surgical, General and Upper GI Surgery Division, Odontostomatologic, Maternal and Child Sciences , University of Verona , Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Bencivenga","sequence":"additional","affiliation":[{"name":"Department and of Surgical, General and Upper GI Surgery Division, Odontostomatologic, Maternal and Child Sciences , University of Verona , Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Rosati","sequence":"additional","affiliation":[{"name":"Department of Surgery , San Raffaele Hospital, San Raffaele Vita-salute University , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uberto Romario","family":"Fumagalli","sequence":"additional","affiliation":[{"name":"Digestive Surgery , European Institute of Oncology , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Marrelli","sequence":"additional","affiliation":[{"name":"Department of Surgery , Siena University Hospital, University of Siena , Siena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Pacelli","sequence":"additional","affiliation":[{"name":"Surgical Unit of Peritoneum and Retroperitoneum Surgery , Fondazione Policlinico Universitario A. Gemelli, IRCCS , Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Macr\u00ec","sequence":"additional","affiliation":[{"name":"Peritoneal Surface Malignancy and Soft Tissue Sarcoma Program , University of Messina , Messina , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annibale","family":"Donini","sequence":"additional","affiliation":[{"name":"General and Emergency Surgery , Santa Maria Della Misericordia Hospital, University of Perugia , Perugia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Torroni","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Public Health, Unit of Epidemiology and Medical Statistics , University of Verona , Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Pavarana","sequence":"additional","affiliation":[{"name":"Department of Oncology , University of Verona , Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"De Manzoni","sequence":"additional","affiliation":[{"name":"Department and of Surgical, General and Upper GI Surgery Division, Odontostomatologic, Maternal and Child Sciences , University of Verona , Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2022,6,7]]},"reference":[{"key":"2025120909233461996_j_pp-2022-0111_ref_001","doi-asserted-by":"crossref","unstructured":"Rijken, A, Lurvink, RJ, Luyer, MDP, Nieuwenhuijzen, GAP, van Erning, FN, van Sandick, JW, et al.. The burden of peritoneal metastases from gastric cancer: a systematic review on the incidence, risk factors and survival. J Clin Med 2021;10:4882. https:\/\/doi.org\/10.3390\/jcm10214882.","DOI":"10.3390\/jcm10214882"},{"key":"2025120909233461996_j_pp-2022-0111_ref_002","doi-asserted-by":"crossref","unstructured":"Al-Batran, SE, Goetze, TO, Mueller, DW, Vogel, A, Winkler, M, Lorenzen, S, et al.. The RENAISSANCE (AIO-FLOT5) trial: effect of chemotherapy alone vs. chemotherapy followed by surgical resection on survival and quality of life in patients with limited-metastatic adenocarcinoma of the stomach or esophagogastric junction\u2014a phase III trial of the German AIO\/CAO-V\/CAOGI. BMC Cancer 2017;17:893. https:\/\/doi.org\/10.1186\/s12885-017-3918-9.","DOI":"10.1186\/s12885-017-3918-9"},{"key":"2025120909233461996_j_pp-2022-0111_ref_003","doi-asserted-by":"crossref","unstructured":"Koemans, WJ, Lurvink, RJ, Grootscholten, C, Verhoeven, RHA, de Hingh, IH, van Sandick, JW. Synchronous peritoneal metastases of gastric cancer origin: incidence, treatment and survival of a nationwide Dutch cohort. Gastric Cancer 2021;24:800\u20139. https:\/\/doi.org\/10.1007\/s10120-021-01160-1.","DOI":"10.1007\/s10120-021-01160-1"},{"key":"2025120909233461996_j_pp-2022-0111_ref_004","doi-asserted-by":"crossref","unstructured":"Al-Batran, SE, Homann, C, Pauligk, C, Illerhaus, G, Martens, UM, Stoehlmacher, J, et al.. Effect of neoadjuvant chemotherapy followed by surgical resection on survival in patients with limited metastatic gastric or gastroesophageal junction cancer. The AIO-FLOT3 trial. JAMA Oncol 2017;3:1237\u201344. https:\/\/doi.org\/10.1001\/jamaoncol.2017.0515.","DOI":"10.1001\/jamaoncol.2017.0515"},{"key":"2025120909233461996_j_pp-2022-0111_ref_005","doi-asserted-by":"crossref","unstructured":"Alyami, M, Bonnot, PE, Mercier, F, Laplace, N, Villeneuve, L, Passot, G, et al.. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) for unresectable peritoneal metastasis from gastric cancer. Eur J Surg Oncol 2021;47:123\u20137. https:\/\/doi.org\/10.1016\/j.ejso.2020.05.021.","DOI":"10.1016\/j.ejso.2020.05.021"},{"key":"2025120909233461996_j_pp-2022-0111_ref_006","doi-asserted-by":"crossref","unstructured":"Glatz, T, Horvath, P, Lang, SA, Archid, R, Nadiradze, G. Staging laparoscopy and Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) for peritoneal metastasis: safe access to the abdomen. Pleura Peritoneum 2019;4:2019004. https:\/\/doi.org\/10.1515\/pp-2019-0004.","DOI":"10.1515\/pp-2019-0004"},{"key":"2025120909233461996_j_pp-2022-0111_ref_007","doi-asserted-by":"crossref","unstructured":"Solass, W, Sempoux, C, Detlefsen, S, Carr, NJ, Bibeau, F. Peritoneal sampling and histological assessment of therapeutic response in peritoneal metastasis: proposal of the peritoneal regression grading score (PRGS). Pleura Peritoneum 2016;1:99\u2013107. https:\/\/doi.org\/10.1515\/pp-2016-0011.","DOI":"10.1515\/pp-2016-0011"},{"key":"2025120909233461996_j_pp-2022-0111_ref_008","doi-asserted-by":"crossref","unstructured":"Giger-Pabst, U, Tempfer, CB. How to perform safe and technically optimized pressurized intraperitoneal aerosol chemotherapy (PIPAC): experience after a consecutive series of 1200 procedures. J Gastrointest Surg 2018;22:2187\u201393. https:\/\/doi.org\/10.1007\/s11605-018-3916-5.","DOI":"10.1007\/s11605-018-3916-5"},{"key":"2025120909233461996_j_pp-2022-0111_ref_009","doi-asserted-by":"crossref","unstructured":"Graziosi, L, Marino, E, Bencivenga, M, D\u2019Ignazio, A, Solaini, L, Ministrini, S, et al.. Looking for a strategy in treating peritoneal gastric cancer carcinomatosis: an Italian multicenter gastric cancer research group\u2019s analysis. World J Surg Oncol 2021;19:334. https:\/\/doi.org\/10.1186\/s12957-021-02442-9.","DOI":"10.1186\/s12957-021-02442-9"},{"key":"2025120909233461996_j_pp-2022-0111_ref_010","doi-asserted-by":"crossref","unstructured":"Sung, H, Ferlay, J, Siegel, RL, Laversanne, M, Soerjomataram, I, Jemal, A, et al.. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209\u201349. https:\/\/doi.org\/10.3322\/caac.21660.","DOI":"10.3322\/caac.21660"},{"key":"2025120909233461996_j_pp-2022-0111_ref_011","doi-asserted-by":"crossref","unstructured":"Lordick, F, Kunzmann, V, Trojan, J, Daum, S, Schenk, M, Kullmann, F, et al.. Intraperitoneal immunotherapy with the bispecific anti- EpCAM x anti-CD3 directed antibody catumaxomab for patients with peritoneal carcinomatosis from gastric cancer: final results of a randomized phase II AIO trial. J Clin Oncol 2018;36:4. https:\/\/doi.org\/10.1200\/jco.2018.36.4_suppl.4.","DOI":"10.1200\/JCO.2018.36.4_suppl.4"},{"key":"2025120909233461996_j_pp-2022-0111_ref_012","doi-asserted-by":"crossref","unstructured":"Van Cutsem, E, Moiseyenko, VM, Tjulandin, S, Majlis, A, Constenla, M, Boni, C, et al.. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first- line therapy for advanced gastric cancer: a report of the V325 study group. J Clin Oncol 2006;24:4991\u20137. https:\/\/doi.org\/10.1200\/jco.2006.06.8429.","DOI":"10.1200\/JCO.2006.06.8429"},{"key":"2025120909233461996_j_pp-2022-0111_ref_013","doi-asserted-by":"crossref","unstructured":"De Manzoni, G, Marrelli, D, Baiocchi, GL, Morgagni, P, Saragoni, L, Degiuli, M, et al.. The Italian research group for gastric cancer (GIRCG) guidelines for gastric cancer staging and treatment: 2015. Gastric Cancer 2017;20:20\u201330. https:\/\/doi.org\/10.1007\/s10120-016-0615-3.","DOI":"10.1007\/s10120-016-0615-3"},{"key":"2025120909233461996_j_pp-2022-0111_ref_014","doi-asserted-by":"crossref","unstructured":"Nadiradze, GJ, Giger-Pabst, U, Zieren, J, Strumberg, D, Solass, W, Reymond, MA. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with low-dose cisplatin and doxorubicin in gastric peritoneal metastasis. Gastrointest Surg 2016;20:367\u201373. https:\/\/doi.org\/10.1007\/s11605-015-2995-9.","DOI":"10.1007\/s11605-015-2995-9"},{"key":"2025120909233461996_j_pp-2022-0111_ref_015","doi-asserted-by":"crossref","unstructured":"Bonnot, PE, Lintis, A, Mercier, F, Benzerdjeb, N, Passot, G, Pocard, M, et al.. FREGAT and BIG-RENAPE networks. Prognosis of poorly cohesive gastric cancer after complete cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy (CYTO-CHIP study). Br J Surg 2021;108:1225\u201335. https:\/\/doi.org\/10.1093\/bjs\/znab200.","DOI":"10.1093\/bjs\/znab200"},{"key":"2025120909233461996_j_pp-2022-0111_ref_016","doi-asserted-by":"crossref","unstructured":"Khomyakov, V, Ryabov, A, Ivanov, A, Bolotina, L, Utkina, A, Volchenko, N, et al.. Bidirectional chemotherapy in gastric cancer with peritoneal metastasis combining intravenous XELOX with intraperitoneal chemotherapy with low-dose cisplatin and Doxorubicin administered as a pressurized aerosol: an open- label, phase-2 study (PIPAC-GA2). Pleura Peritoneum 2016;1:159\u201366. https:\/\/doi.org\/10.1515\/pp-2016-0017.","DOI":"10.1515\/pp-2016-0017"},{"key":"2025120909233461996_j_pp-2022-0111_ref_017","doi-asserted-by":"crossref","unstructured":"Alyami, M, Gagniere, J, Sgarbura, O, Cabelguenne, D, Villeneuve, L, Pezet, D, et al.. Multicentric initial experience with the use of the pressurized intraperitoneal aerosol chemotherapy (PIPAC) in the management of unresectable peritoneal carcinomatosis. Eur J Surg Oncol 2017;43:2178\u201383. https:\/\/doi.org\/10.1016\/j.ejso.2017.09.010.","DOI":"10.1016\/j.ejso.2017.09.010"},{"key":"2025120909233461996_j_pp-2022-0111_ref_018","doi-asserted-by":"crossref","unstructured":"Di Giorgio, A, Schena, CA, El Halabieh, MA, Abatini, C, Vita, E, Strippoli, A, et al.. Systemic chemotherapy and pressurized intraperitoneal aerosol chemotherapy (PIPAC): a bidirectional approach for gastric cancer peritoneal metastasis. Surg Oncol 2020;34:270\u20135. https:\/\/doi.org\/10.1016\/j.suronc.2020.05.006.","DOI":"10.1016\/j.suronc.2020.05.006"}],"container-title":["Pleura and Peritoneum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/pp-2022-0111\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/pp-2022-0111\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T11:01:05Z","timestamp":1765278065000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/pp-2022-0111\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,7]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,6,6]]},"published-print":{"date-parts":[[2022,9,13]]}},"alternative-id":["10.1515\/pp-2022-0111"],"URL":"https:\/\/doi.org\/10.1515\/pp-2022-0111","relation":{},"ISSN":["2364-768X"],"issn-type":[{"value":"2364-768X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,7]]}}}