Published online May 21, 2018. doi: 10.3748/wjg.v24.i19.2130
Peer-review started: January 31, 2018
First decision: February 24, 2018
Revised: March 22, 2018
Accepted: March 31, 2018
Article in press: March 31, 2018
Published online: May 21, 2018
We report the first application of pressurized intraperitoneal aerosol chemotherapy (PIPAC) as a rescue therapy before palliative D2 gastrectomy combined with liver metastasectomy performed in a 49-year-old woman with peritoneal carcinomatosis who was primarily diagnosed with and underwent surgery for a Krukenberg tumor. The PIPAC procedure was performed with the use of cisplatin at 7.5 mg/m2 and doxorubicin at 1.5 mg/m2 for 30 min at 37 °C. Eight weeks after the PIPAC procedure, the patient underwent open classic D2 gastrectomy with the creation of a Roux-en-Y anastomosis (RNY) combined with liver metastasectomy. The patient underwent the classic protocol for chemotherapy combined with Xeloda. The patient felt better and returned to her daily activities. Multicenter data should be gathered to confirm the usefulness of PIPAC as a rescue or neoadjuvant supportive therapy in a very select group of patients who have been recently qualified to undergo classic chemotherapy or standard oncologic surgical procedures.
Core tip: The Krukenberg tumor (KT) is very often misdiagnosed as primary ovarian cancer and may be occasionally diagnosed during a clinical work-up. The fast implementation of effective treatment is always necessary. This case might contribute to future confirmation of the usefulness of pressurized intraperitoneal aerosol chemotherapy as a rescue or neoadjuvant, supportive form of therapy in a very select group of patients. This clinical development might be particularly important for patients with a KT presentation of gastric cancer who have been recently qualified to undergo classic chemotherapy or standard oncologic surgical procedures.