First Indian Study on Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) Procedure for Advanced Peritoneal Carcinomatosis Secondary to Epithelial Ovarian Cancer

Background: Peritoneal carcinomatosis is a common evolution in ovarian cancers. Although majority of patients have option of cytoreductive surgery and HIPEC, a few with recurrent cancers who are not eligible for curative approach can undergo pressurized intraperitoneal aerosol chemotherapy (PIPAC) which is an emerging field of research with major therapeutic potential. It is a safe and innovative approach, which enhances the effect of chemotherapy without major toxicity. Methods: Between June 2017 and December 2017, 9 PIPAC applications in 3 patients with pressurized aerosol solution of cisplatin and doxorubicin every 6 weeks at 37 °C and 12 mmHg for 30 min were performed. The patient demographics, perioperative findings, adverse events, and outcomes were prospectively recorded. Results: Nine PIPAC administrations were performed in 3 patients with peritoneal carcinomatosis secondary to ovarian cancer. The median hospital stay was 1 day. There were no major perioperative complications. CTCAE grade 2 was observed in 1 patient, for abdominal pain and nausea. Renal and hepatic functions were not impaired. Of the 3 patients, two patients had partial response, and one had stable disease. Conclusion: Our results show the feasibility and safety of PIPAC in Indian patients with advanced ovarian cancer. The procedure has low morbidity with no mortality with short learning curve. It can be easily adopted as a palliative option apart from systemic chemotherapy. © 2018, Association of Gynecologic Oncologists of India.