Pressurised intraperitoneal aerosol chemotherapy (PIPAC): the first Australian experience

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Peritoneal metastases often present a challenge for curative treatment.
• Pressurised intraperitoneal aerosol chemotherapy (PIPAC) is an innovative surgical technique delivering chemotherapy as an aerosol directly into the peritoneal cavity.
• This method utilizes a hyperbaric capnoperitoneum established laparoscopically.

Purpose of the Study:

• To assess the feasibility and safety of PIPAC in an Australian patient cohort.
• To evaluate post-operative complications, length of stay, and quality of life following PIPAC.

Main Methods:

• A cohort analysis of prospectively collected data from two Australian hospitals.
• Patients were planned for three PIPAC procedures, spaced six weeks apart.
• Outcomes measured included complications (30-day mortality), length of stay, and EORTC QLQ-C30 quality of life scores.

Main Results:

• 18 patients completed 50 PIPAC procedures, with 13 undergoing two or more.
• Colorectal cancer was the most common primary malignancy (n=8).
• No grade five complications or 30-day mortality were recorded. Median length of stay was one day. Quality of life scores improved post-treatment.

Conclusions:

• PIPAC is a feasible, safe, and well-tolerated procedure in the Australian population.
• The study demonstrated a lack of severe complications and no 30-day mortality.
• This is the first investigation of PIPAC implementation in Australia, providing valuable initial data despite sample size limitations.