Clinical Research Directory

Inclusion Criteria: For Unesectable PM Group: * Age ≥ 21 years old * ECOG \< 3 * Fit for systemic chemotherapy treatment * Adequate bone marrow function (haemoglobin ≥ 8.0 mmol/L, neutrophils ≥ 1.5X109/L, platelets ≥ 100X109/L * Adequate renal function (e-GFR \> 30mls/min for patients undergoing PIPAC with oxaliplatin; e-GFR \> 60mls/min for patients undergoing PIPAC with Doxorubicine/Cisplatin) * Adequate liver function (Total bilirubin \< 1.5 upper limit of normal; ALT and AST\< 3 upper limit of normal) * No contraindications to chemotherapy agents oxaliplatin, doxorubicin/ cisplatin * No contraindications to general anaesthesia and diagnostic laproscopy procedure * Normal left ventricular ejection fraction (for patients undergoing PIPAC with doxorubicin/ cisplatin) * Histological/ cytological proof of PM from GI, HPB, Gynaecology, Breast, Sarcoma primaries * Peritoneal-dominant metastatic disease For the Extensive PM Group: All the above mentioned criteria as for the unresectable group, with the addition of the following: * Not suitable for curative cytoreductive surgery (CRS) \& hyperthermic intraperitoneal chemotherapy (HIPEC) surgery after diagnostic laproscopy - PCI \> 18 in LGI, PCI \> 6 in UGI ECOG \< 3 * In UGI PM patients, progression while on bidirectional chemotherapy Exclusion Criteria: * Patient is medically unfit for surgery due to concurrent medical comorbidities, including but not limited to intestinal obstruction, multiple sites of metastases * Any medical or psychiatric condition(s) which would preclude informed consent * Patient is pregnant or nursing * GI PM patients with PCI \>6 but are treatment naive (these patients should undergo standard treatment - bidirectional intravenous and intraperitoneal chemotherapy)