[Intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: Experience from Singapore]

Systemic chemotherapy currently remains the standard treatment for gastric cancer with peritoneal metastasis (GCPM). However, the plasma-peritoneum barrier significantly limits drug penetration into the peritoneal cavity, resulting in the poor prognosis for GCPM patients. In Singapore, intraperitoneal chemotherapy has been demonstrated as a safe and effective approach for GCPM treatment following the implementation of various modalities including pressurized intraperitoneal aerosol chemotherapy (PIPAC), catheter-based intraperitoneal (IP) chemotherapy and conventional hyperthermic intraperitoneal chemotherapy (HIPEC). This article reviews the evolution of intraperitoneal chemotherapy in Singapore and highlights several important clinical trials. Looking forward, the bidirectional approach combining intraperitoneal and systemic chemotherapy will be further refined through the integration of novel drug combinations, optimization of delivery techniques, and expansion of clinical research.