[PIPAC and HIPEC-competing or supplementary therapeutic procedures for peritoneal metastases]

Peritoneal carcinomatosis remains a therapeutic challenge. The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is currently the only potentially curative option with good results. For good oncological results a complete macroscopic cytoreduction is essential. This mostly requires a complex operative procedure with significant morbidity and mortality. Therefore, multimodal treatment is limited to a few highly selected patients. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new minimally invasive approach, the value and spectrum of applications of which are still under investigation; however, the articles on PIPAC published so far are encouraging and PIPAC is therefore a possible palliative therapy option for patients who are not eligible for CRS and HIPEC. The aim of this review is to present a summary of the recent data regarding CRS-HIPEC and PIPAC.