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PIPAC (Pressurized IntraPeritoneal Aerosol Chemotherapy) vs HIPEC (Hyperthermic Intraperitoneal Chemotherapy)

Posted on: October 12, 2023 *Updated on: May 27, 2024

PIPAC (Pressurized IntraPeritoneal Aerosol Chemotherapy) compared to HIPEC (Hyperthermic Intraperitoneal Chemotherapy)
October 12, 2023

Here’s a comparison:

PIPAC (Pressurized IntraPeritoneal Aerosol Chemotherapy):

  • Method: Administers chemotherapy as a pressurized aerosol directly into the abdomen.
  • Duration: About 2 hours.
  • Recovery: Often discharged on the same day as the procedure.
  • Advantages:
    Less invasive.
    Can be used as a preparatory step for patients who are ineligible for CRS (Cytoreductive Surgery) combined with HIPEC due to large tumor size or poor health.
    Can potentially shrink tumors to make CRS and HIPEC a viable option.
    Generally doesn’t require special preoperative preparations.

HIPEC (Hyperthermic Intraperitoneal Chemotherapy):

  • Method: Involves applying heated chemotherapy as a wash directly into the abdomen, typically following CRS to remove visible tumors.
  • Duration: The combined surgery and HIPEC procedure can last between 8-14 hours.
  • Recovery: Hospital stay is generally between 10 to 12 days.
  • Advantages:
    Effective in improving life expectancy for peritoneal mesothelioma patients when combined with surgery.
    Direct application ensures high concentrations of chemotherapy at the site of the tumor while minimizing systemic exposure.

In summary, both treatments have their place in the therapeutic arsenal against peritoneal mesothelioma. While HIPEC combined with surgery has a longer track record and has shown efficacy in prolonging survival, PIPAC offers a less invasive alternative that can be particularly beneficial for patients who are currently ineligible for HIPEC due to the size of their tumors or their overall health status. The choice between these two therapies, or the decision to use them sequentially, should be tailored based on individual patient circumstances and discussed thoroughly with a medical oncologist specializing in peritoneal malignancies.