{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:59:54Z","timestamp":1789171194194,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: PIPAC is an innovative treatment that delivers low-dose aerosolized chemotherapy into the abdominal cavity of patients with peritoneal surface malignancies (PSMs). However, its role in the multimodal management of PSMs is unclear. Methods: We retrospectively analyzed data from 64 patients who underwent PIPAC for PSMs of a primary or secondary origin between June 2020 and December 2024 (median age of 64 years). Primary tumor sites included gastric (42.2%), colorectal (23.4%), ovarian cancer (21.9%), and others (12.5%). The median PCI was 15 (IQR 9\u201325), with ascites present in 60.9% of cases and a positive cytology in 48.4%. Results: A total of 82 PIPAC sessions were performed in 64 patients. The mean operation time was 96 min. Severe adverse events, defined as the Common Terminology Criteria for Adverse Events (CTCAE) of a grade \u2265 2, occurred in four patients (6.2%). The median hospital stay was 3 days, and systemic chemotherapy was resumed within 14 days after the procedure in 27 patients. Among the entire cohort, 37.5% received bidirectional therapy and 62.5% received palliative treatment, with a lower peritoneal cancer index (PCI) in the bidirectional group (9.5 vs. 23). The median overall survival (OS) was 32 months from diagnosis. Sixteen patients (25%) underwent two or more PIPAC sessions and showed an advantage in survival compared to patients who underwent only one procedure (3-year OS: 63.2% vs. 38.4%, p 0.030). Conversion surgery was achieved in 34.4%. Patients treated with a bidirectional intent demonstrated a longer OS (3-year: 66.0% vs. 33.9%, p 0.011). Colorectal and ovarian tumors exhibited better long-term outcomes compared to gastric cancer. Conclusions: PIPAC is a promising treatment for PSMs, with a low morbidity rate. Its favorable safety and short interval to systemic therapy resumption support its use as part of a bidirectional strategy.<\/jats:p>","DOI":"10.3390\/cancers17121938","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T03:44:58Z","timestamp":1749613498000},"page":"1938","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pressurized Intra-Peritoneal Aerosol Chemotherapy (PIPAC) for Peritoneal Malignancies with Palliative and Bidirectional Intent"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2066-1618","authenticated-orcid":false,"given":"Daniele","family":"Marrelli","sequence":"first","affiliation":[{"name":"Unit\u00a0of General Surgery, Department of Oncology, AOUS, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2862-6788","authenticated-orcid":false,"given":"Ludovico","family":"Carbone","sequence":"additional","affiliation":[{"name":"Unit\u00a0of General Surgery, Department of Oncology, AOUS, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2804-2814","authenticated-orcid":false,"given":"Daniele","family":"Fusario","sequence":"additional","affiliation":[{"name":"Unit\u00a0of General Surgery, Department of Oncology, AOUS, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Petrioli","sequence":"additional","affiliation":[{"name":"Unit of Medical Oncology, Department of Oncology, AOUS, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8515-2414","authenticated-orcid":false,"given":"Gianmario Edoardo","family":"Poto","sequence":"additional","affiliation":[{"name":"Unit\u00a0of General Surgery, Department of Oncology, AOUS, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Grassi","sequence":"additional","affiliation":[{"name":"Unit\u00a0of General Surgery, Department of Oncology, AOUS, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Piagnerelli","sequence":"additional","affiliation":[{"name":"Unit\u00a0of General Surgery, Department of Oncology, AOUS, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9050-4127","authenticated-orcid":false,"given":"Stefania Angela","family":"Piccioni","sequence":"additional","affiliation":[{"name":"Unit\u00a0of General Surgery, Department of Oncology, AOUS, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Ricci","sequence":"additional","affiliation":[{"name":"Interventional Radiology Unit, Department of Emergency, AOUS, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Bianco","sequence":"additional","affiliation":[{"name":"Hygiene Prevention and Protection Area, Pharmacy Unit, AOUS, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6778-6894","authenticated-orcid":false,"given":"Maria Antonietta","family":"Mazzei","sequence":"additional","affiliation":[{"name":"Unit of Diagnostic Imaging, Department of Medicine Surgery and Neurosciences, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2218-3771","authenticated-orcid":false,"given":"Stefano","family":"Lazzi","sequence":"additional","affiliation":[{"name":"Pathological Anatomy Unit, Department of Medical Biotechnology, University of Siena, 51300 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4122-1259","authenticated-orcid":false,"given":"Franco","family":"Roviello","sequence":"additional","affiliation":[{"name":"Unit\u00a0of General Surgery, Department of Oncology, AOUS, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2717","DOI":"10.1002\/ijc.25596","article-title":"Predictors and Survival of Synchronous Peritoneal Carcinomatosis of Colorectal Origin: A Population-based Study","volume":"128","author":"Lemmens","year":"2011","journal-title":"Int. J. Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Carbone, L., Incognito, G.G., Incognito, D., Nibid, L., Caruso, G., Berretta, M., Taffon, C., Palumbo, M., Perrone, G., and Roviello, F. (2025). Clinical Implications of Epithelial-to-Mesenchymal Transition in Cancers Which Potentially Spread to Peritoneum. Clin. Transl. Oncol., online ahead of print.","DOI":"10.1007\/s12094-024-03837-2"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Manzanedo, I., Pereira, F., Cascales-Campos, P., Mu\u00f1oz-Casares, C., Asensio, E., Torres-Melero, J., Prada-Villaverde, A., Caravaca-Garc\u00eda, I., Guti\u00e9rrez-Calvo, A., and Vaqu\u00e9, J. (2023). Treatment of Peritoneal Surface Malignancies by Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Spain: Results of the National Registry of the Spanish Group of Peritoneal Oncologic Surgery (REGECOP). J. Clin. Med., 12.","DOI":"10.3390\/jcm12113774"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"9098","DOI":"10.1245\/s10434-021-10193-w","article-title":"HIPEC Methodology and Regimens: The Need for an Expert Consensus","volume":"28","author":"Bhatt","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1245\/s10434-013-3213-1","article-title":"Intraperitoneal Chemotherapy of Peritoneal Carcinomatosis Using Pressurized Aerosol as an Alternative to Liquid Solution: First Evidence for Efficacy","volume":"21","author":"Solass","year":"2014","journal-title":"Ann. Surg. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"106976","DOI":"10.1016\/j.ejso.2023.07.002","article-title":"A Narrative Review of What Can HIPEC Do","volume":"49","author":"Sugarbaker","year":"2023","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e368","DOI":"10.1016\/S1470-2045(19)30318-3","article-title":"Pressurised Intraperitoneal Aerosol Chemotherapy: Rationale, Evidence, and Potential Indications","volume":"20","author":"Alyami","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S242","DOI":"10.21037\/jgo-20-257","article-title":"Pressurized Intraperitoneal Aerosol Chemotherapy with Oxaliplatin (PIPAC-OX) in Patients with Colorectal Peritoneal Metastases\u2014A Systematic Review","volume":"12","author":"Lurvink","year":"2021","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Marrelli, D., Ansaloni, L., Federici, O., Asero, S., Carbone, L., Marano, L., Baiocchi, G., Vaira, M., Coccolini, F., and Di Giorgio, A. (2022). Cytoreductive Surgery (CRS) and HIPEC for Advanced Ovarian Cancer with Peritoneal Metastases: Italian PSM Oncoteam Evidence and Study Purposes. Cancers, 14.","DOI":"10.3390\/cancers14236010"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.ejso.2020.05.021","article-title":"Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) for Unresectable Peritoneal Metastasis from Gastric Cancer","volume":"47","author":"Alyami","year":"2021","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Giger-Pabst, U., Demtr\u00f6der, C., Falkenstein, T.A., Ouaissi, M., G\u00f6tze, T.O., Rezniczek, G.A., and Tempfer, C.B. (2018). Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) for the Treatment of Malignant Mesothelioma. BMC Cancer, 18.","DOI":"10.1186\/s12885-018-4363-0"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1007\/s10585-018-9925-7","article-title":"Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) for Peritoneal Metastases of Pancreas and Biliary Tract Cancer","volume":"35","author":"Horvath","year":"2018","journal-title":"Clin. Exp. Metastasis"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1093\/bjs\/znad061","article-title":"Bi-Directional Chemotherapy for Peritoneal Metastases","volume":"110","author":"So","year":"2023","journal-title":"Br. J. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Ploug, M., Graversen, M., Pfeiffer, P., and Mortensen, M.B. (2020). Bidirectional Treatment of Peritoneal Metastasis with Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) and Systemic Chemotherapy: A Systematic Review. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-6572-6"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/00000658-199501000-00004","article-title":"Peritonectomy Procedures","volume":"221","author":"Sugarbaker","year":"1995","journal-title":"Ann. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Jacquet, P., and Sugarbaker, P.H. (1996). Clinical Research Methodologies in Diagnosis and Staging of Patients with Peritoneal Carcinomatosis. Peritoneal Carcinomatosis: Principles of Management, Springer.","DOI":"10.1007\/978-1-4613-1247-5"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ejca.2016.03.081","article-title":"RECIST 1.1\u2014Update and Clarification: From the RECIST Committee","volume":"62","author":"Schwartz","year":"2016","journal-title":"Eur. J. Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3504","DOI":"10.1245\/s10434-013-3039-x","article-title":"Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC): Occupational Health and Safety Aspects","volume":"20","author":"Zieren","year":"2013","journal-title":"Ann. Surg. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"5733","DOI":"10.1245\/s10434-023-13572-7","article-title":"Bidirectional Approach with PIPAC and Systemic Chemotherapy for Patients with Synchronous Gastric Cancer Peritoneal Metastases (GCPM)","volume":"30","author":"Casella","year":"2023","journal-title":"Ann. Surg. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1515\/pp-2021-0125","article-title":"Consensus Statement on Safety Measures for Pressurized Intraperitoneal Aerosol Chemotherapy","volume":"6","author":"Clerc","year":"2021","journal-title":"Pleura Peritoneum"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1515\/pp-2022-0102","article-title":"Consensus Statement for Treatment Protocols in Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC)","volume":"7","author":"Sgarbura","year":"2022","journal-title":"Pleura Peritoneum"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1001\/jamaoncol.2015.2639","article-title":"Validity and Reliability of the US National Cancer Institute\u2019s Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)","volume":"1","author":"Dueck","year":"2015","journal-title":"JAMA Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1515\/pp-2016-0011","article-title":"Peritoneal Sampling and Histological Assessment of Therapeutic Response in Peritoneal Metastasis: Proposal of the Peritoneal Regression Grading Score (PRGS)","volume":"1","author":"Solass","year":"2016","journal-title":"Pleura Peritoneum"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"101523","DOI":"10.1016\/j.suronc.2021.101523","article-title":"A Novel Treatment Protocol with 6 Cycles of Neoadjuvant Chemotherapy Followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Stage III Primary Ovarian Cancer","volume":"37","author":"Marrelli","year":"2021","journal-title":"Surg. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2165","DOI":"10.1245\/s10434-018-6335-7","article-title":"Palliative Management of Peritoneal Metastases","volume":"25","author":"Lambert","year":"2018","journal-title":"Ann. Surg. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S259","DOI":"10.21037\/jgo-20-497","article-title":"The Emergence of Pressurized Intraperitoneal Aerosol Chemotherapy as a Palliative Treatment Option for Patients with Diffuse Peritoneal Metastases: A Narrative Review","volume":"12","author":"Lurvink","year":"2021","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.ejso.2020.08.020","article-title":"Current Practice of Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC): Still Standardized or on the Verge of Diversification?","volume":"47","author":"Sgarbura","year":"2021","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1002\/bjs.10521","article-title":"Systematic Review of Pressurized Intraperitoneal Aerosol Chemotherapy for the Treatment of Advanced Peritoneal Carcinomatosis","volume":"104","author":"Grass","year":"2017","journal-title":"Br. J. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.ejso.2019.06.028","article-title":"Unresectable Peritoneal Metastasis Treated by Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) Leading to Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy","volume":"47","author":"Alyami","year":"2021","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1093\/bjs\/znac284","article-title":"Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC): Updated Systematic Review Using the IDEAL Framework","volume":"110","author":"Baggaley","year":"2022","journal-title":"Br. J. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s00404-018-4784-7","article-title":"Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) for Peritoneal Carcinomatosis: Systematic Review of Clinical and Experimental Evidence with Special Emphasis on Ovarian Cancer","volume":"298","author":"Tempfer","year":"2018","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s11605-015-2995-9","article-title":"Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) with Low-Dose Cisplatin and Doxorubicin in Gastric Peritoneal Metastasis","volume":"20","author":"Nadiradze","year":"2016","journal-title":"J. Gastrointest. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1111\/codi.13130","article-title":"Pressurized Intraperitoneal Aerosol Chemotherapy with Oxaliplatin in Colorectal Peritoneal Metastasis","volume":"18","author":"Solass","year":"2016","journal-title":"Color. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Di Giorgio, A., Macr\u00ec, A., Ferracci, F., Robella, M., Visaloco, M., De Manzoni, G., Sammartino, P., Sommariva, A., Biacchi, D., and Roviello, F. (2023). 10 Years of Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC): A Systematic Review and Meta-Analysis. Cancers, 15.","DOI":"10.3390\/cancers15041125"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1515\/pp-2021-0108","article-title":"The ISSPP PIPAC Database: Design, Process, Access, and First Interim Analysis","volume":"6","author":"Mortensen","year":"2021","journal-title":"Pleura Peritoneum"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1002\/jso.27794","article-title":"Conversion Surgery for Gastric Cancer with PM","volume":"130","author":"Kitai","year":"2024","journal-title":"J. Surg. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1515\/pp-2016-0017","article-title":"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)","volume":"1","author":"Khomyakov","year":"2016","journal-title":"Pleura Peritoneum"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1758835919846402","DOI":"10.1177\/1758835919846402","article-title":"Pressurized Intraperitoneal Aerosol Chemotherapy with Low-Dose Cisplatin and Doxorubicin (PIPAC C\/D) in Patients with Gastric Cancer and Peritoneal Metastasis: A Phase II Study","volume":"11","author":"Struller","year":"2019","journal-title":"Ther. Adv. Med. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Ramalho-Vasconcelos, F., Gomes, R., Bou\u00e7a-Machado, R., Aral, M., Nogueiro, J., Bou\u00e7a-Machado, T., Sousa-Pinto, B., and San-tos-Sousa, H. (2024). Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in the Treatment of Gastric Cancer: Feasibility, Efficacy and Safety\u2014A Systematic Review and Meta-Analysis. J. Clin. Med., 13.","DOI":"10.3390\/jcm13113320"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1007\/s12029-021-00698-8","article-title":"Effect of Pressurized Intraperitoneal Aerosol Chemotherapy on the Survival Rate of Patients with Peritoneal Carcinomatosis of Gastric Origin","volume":"53","author":"Tidadini","year":"2022","journal-title":"J. Gastrointest. Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"4433","DOI":"10.1245\/s10434-023-13278-w","article-title":"Feasibility and Safety of Laparoscopic D2 Gastrectomy in Combination with Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in Patients with Gastric Cancer at High Risk of Recurrence-The PIPAC-OPC4 Study","volume":"30","author":"Graversen","year":"2023","journal-title":"Ann. Surg. Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.ejso.2018.02.014","article-title":"Multicenter Comprehensive Methodological and Technical Analysis of 832 Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) Interventions Performed in 349 Patients for Peritoneal Carcinomatosis Treatment: An International Survey Study","volume":"44","author":"Nowacki","year":"2018","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S271","DOI":"10.21037\/jgo-2020-22","article-title":"PIPAC May Work but More Data Is Needed","volume":"12","author":"Sugarbaker","year":"2021","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1515\/pp-2022-0111","article-title":"Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in Multimodal Therapy for Patients with Oligometastatic Peritoneal Gastric Cancer: A Randomized Multicenter Phase III Trial PIPAC VEROne","volume":"7","author":"Casella","year":"2022","journal-title":"Pleura Peritoneum"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/12\/1938\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:49:45Z","timestamp":1760032185000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/12\/1938"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,11]]},"references-count":44,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["cancers17121938"],"URL":"https:\/\/doi.org\/10.3390\/cancers17121938","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,11]]}}}