The following is a summary of “Comparing patient reported abdominal pain between patients treated with oxaliplatin-based pressurized intraperitoneal aerosol chemotherapy (PIPAC-OX) and primary colorectal cancer surgery,” published in the November 2023 issue of Surgery by Vlasakker et al.

Oxaliplatin-based pressurized intraperitoneal aerosol chemotherapy (PIPAC-OX) is a developing treatment for unresectable colorectal peritoneal metastases. Past studies from the study group have highlighted the persistence of abdominal pain in patients following PIPAC-OX treatment. Yet, little is known about how this pain compares to that experienced after standard colorectal cancer surgery. This study aims to contrast the incidence of abdominal pain following PIPAC-OX treatment with that following primary tumor surgery. Data from two Dutch cohorts were analyzed using patient-reported abdominal pain scores (EORTC QLQ-CR-29). Scores ranged from 0 to 100, where higher scores indicated more severe abdominal pain. 

The presence of abdominal pain was compared between the two groups at baseline and four weeks post-treatment. The analysis encompassed 20 patients who underwent PIPAC-OX and 322 patients who underwent primary tumor surgery. Initially, the two groups had no significant differences in baseline abdominal pain (mean 20 for PIPAC-OX vs. 18 for surgery; p = 0.688). However, four weeks post-treatment, patients who had undergone PIPAC-OX reported significantly worse abdominal pain (39 vs. 15 for surgery; p < 0.001; Cohen’s d = 0.99). 

The disparity in abdominal pain over time between the groups was notably different (mean difference: 19 for PIPAC-OX vs. − 3 for surgery; p = 0.004; Cohen’s d = 0.88). Evidently, PIPAC-OX led to considerably more postoperative abdominal pain compared to primary tumor surgery. These findings underscore the importance of adequate pain management during and after PIPAC-OX and emphasize the necessity for further research to alleviate or prevent such abdominal pain.

Source: nature.com/articles/s41598-023-47510-0