Standardizing eligibility and patient selection for Pressurized Intraperitoneal Aerosol Chemotherapy: A Delphi...

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is a minimally invasive technique for delivering chemotherapy to patients with peritoneal metastasis.
• Standardization of PIPAC protocols is crucial for consistent patient outcomes.
• This study aimed to achieve expert consensus on key aspects of PIPAC implementation.

Purpose of the Study:

• To establish a consensus on eligibility criteria for PIPAC procedures.
• To define optimal patient selection guidelines for PIPAC.
• To explore expert opinions on chemotherapy choices within PIPAC protocols.

Main Methods:

• A modified Delphi study involving an international panel of 45 experts was conducted over three rounds.
• Experts anonymously rated statements on a 4-point Likert scale, with consensus defined as ≥75% agreement.
• A steering group of seven oncologists and surgeons formulated initial statements based on evidence and expert opinion.

Main Results:

• Consensus was reached on 40 definitive statements covering PIPAC eligibility and patient selection after three rounds of expert review.
• A high level of agreement (≥80%) was achieved for most statements by the final round.
• The selection of first- and second-line chemotherapy agents for PIPAC remained a point of contention among experts, failing to reach consensus.

Conclusions:

• The Delphi study provides practical, consensus-based guidance for PIPAC eligibility and patient selection.
• Further research and long-term data are needed to standardize chemotherapy choices in PIPAC.
• The findings contribute to the ongoing efforts to standardize Pressurized Intraperitoneal Aerosol Chemotherapy practices globally.