{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T13:45:43Z","timestamp":1776951943453,"version":"3.51.4"},"reference-count":75,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is an emerging technique for delivering chemotherapy directly to the peritoneum via a pressurized aerosol. Its growing attention stems from its effectiveness in treating peritoneal carcinomatosis (PC) originating from various primary tumors, with gastric cancer (GC) being among the most prevalent. This study aimed to systematically investigate PIPAC\u2019s therapeutic role in gastric cancer peritoneal metastasis (GCPM). Methods: The systematic review and meta-analysis followed the PRISMA 2020 guidelines, searching Pubmed, Web of Science, and SCOPUS databases. The meta-analysis of relative risks and mean differences compared patients undergoing one or two PIPAC sessions with those completing three or more, assessing various outcomes. Results: Eighteen studies underwent qualitative analysis, and four underwent quantitative analysis. Patients with three or more PIPAC procedures had shorter hospital stays (MD = \u22121.2; 95%CI (\u22121.9; \u22120.5); p &lt; 0.001), higher rates of histopathological response (RR = 1.77, 95%CI 1.08; 2.90; p = 0.023), and significantly improved overall survival (MD = 6.0; 95%CI 4.2; 7.8; p &lt; 0.001). Other outcomes showed no significant differences. Conclusions: PIPAC demonstrated efficacy in carefully selected patients, enhancing histopathologic response rates and overall survival without prolonging hospital stays. This study underscores the necessity for randomized controlled trials and precise selection criteria to refine PIPAC\u2019s implementation in clinical practice.<\/jats:p>","DOI":"10.3390\/jcm13113320","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T11:48:50Z","timestamp":1717501730000},"page":"3320","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in the Treatment of Gastric Cancer: Feasibility, Efficacy and Safety\u2014A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7354-0903","authenticated-orcid":false,"given":"Francisca","family":"Ramalho-Vasconcelos","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"given":"Raquel","family":"Gomes","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3756-2763","authenticated-orcid":false,"given":"Raquel","family":"Bou\u00e7a-Machado","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Molecular Jo\u00e3o Lobo Antunes\u2014Edif\u00edcio Egas Moniz, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal"}]},{"given":"Marisa","family":"Aral","sequence":"additional","affiliation":[{"name":"S\u00e3o Jo\u00e3o Local Health Unit, Surgery Department, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0539-6003","authenticated-orcid":false,"given":"Jorge","family":"Nogueiro","sequence":"additional","affiliation":[{"name":"S\u00e3o Jo\u00e3o Local Health Unit, Surgery Department, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8954-9961","authenticated-orcid":false,"given":"Tiago","family":"Bou\u00e7a-Machado","sequence":"additional","affiliation":[{"name":"S\u00e3o Jo\u00e3o Local Health Unit, Surgery Department, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1277-3401","authenticated-orcid":false,"given":"Bernardo","family":"Sousa-Pinto","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"MEDCIDS\u2014Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"CINTESIS\u2014Centre for Health Technologies and Services Research, University of Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6176-5654","authenticated-orcid":false,"given":"Hugo","family":"Santos-Sousa","sequence":"additional","affiliation":[{"name":"S\u00e3o Jo\u00e3o Local Health Unit, Obesity Integrated Responsibility Unit (CRI-O), 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101404","DOI":"10.1016\/j.eclinm.2022.101404","article-title":"The current and future incidence and mortality of gastric cancer in 185 countries, 2020\u20132040: A population-based modelling study","volume":"47","author":"Morgan","year":"2022","journal-title":"EClinicalMedicine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"256","DOI":"10.3390\/hygiene3030019","article-title":"Gastric Cancer Epidemiology: Current Trend and Future Direction","volume":"3","author":"Iwu","year":"2023","journal-title":"Hygiene"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Manzanedo, I., Pereira, F., P\u00e9rez-Viejo, E., and Serrano, \u00c1. 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