Fig. 1

a Tumor regression induced by PIPAC treatments. Bars indicate tumor regression in individual patients undergoing PIPAC cycles 1 to 5. Inset with dotted line: linear regression (p < 0.001; regression coefficient = 0.587). Tumor regression grade 0 to 4 according to Dworak et al.: 0, no regression; 1, minimal regression; 2, moderate regression; 3, major regression; 4, complete regression. b MRI and CT scans of a 59 year old patient who refused any systemic chemotherapy and not being a candidate for cytoreductive surgery and HIPEC. Upper panel: Preoperative MRI before PIPAC#1 showing the upper abdomen with pronounced ascites perihepatic, in the left upper abdomen (a1) and in the lower abdomen/pelvis with a trapped small intestine (a2). During PIPAC#1, 6 l of ascites were evacuated. Lower panel: CT scan of the upper abdomen 12 weeks after PIPAC#1 (6 weeks after PIPAC#2) and preoperatively before PIPAC #3, showing only a moderate amount of ascites perihepatic, in the left upper abdomen (b1) and pelvis (b2). 500 ml ascites was removed during PIPAC#3. c In 25 patients who received at least one PIPAC cycle, a median overall survival of 26.6 months (95% CI: 9.5 to 43.7) was observed after the first PIPAC application (open and laparoscopic). d Quality of life scores according to the EORTC QLQ-C30 questionnaire during PIPAC treatment cycles 1 (N = 21), 2 (N = 18), 3 (N = 11), and 4/5 (N = 11), respectively. Box plots: lower/upper boundaries of boxes represent the 25th/75th percentiles, thick lines the medians, and the whiskers the 10th and 90th percentiles, respectively; white circles are the means (with regression lines). GHS/QoL, global health score, quality of life; PF, physical functioning; RF, role functioning; EF, emotional functioning; CF, cognitive functioning; SF, social functioning; FA, fatigue; NV, nausea and vomiting; PA, pain; DY, dyspnoea; SL, insomnia; AP, appetite loss; CO, constipation; DI, diarrhoea; FI, financial difficulties