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56 First indian study on pressurized intraperitoneal aerosol chemotherapy (PIPAC) for advanced peritoneal carcinomatosis secondary to epithelial ovarian cancer and its impact on quality of life
  1. S Somashekar1,
  2. K Ashwin1,
  3. C Rohit Kumar1,
  4. A Vijay Kumar1,
  5. A rauthan2 and
  6. Y Ramya1
  1. 1Manipal Comphrensive Cancer Centre, Surgical Oncology, Bengaluru, India
  2. 2Manipal Comphrensive Cancer Centre, Medical Oncology, Bengaluru, India


Objectives 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). It is a safe and innovative approach, which enhances the effect of intraperitoneal delivery of chemotherapy without major toxicity.

Methods Between June 2017 and December 2018, 35 PIPAC applications were done in 15 patients using cisplatin and doxorubicin. The patient demographics, perioperative findings, adverse events, and outcomes were prospectively recorded.

Results 35 PIPAC administrations were performed in 15 patients with peritoneal carcinomatosis secondary to ovarian cancer. The median hospital stay was 1.5 day. 10 patients completed all 3 pipac. One patient had bowel perforation; one had major bleeding during the procedure. CTCAE grade 2 was observed in 7 patients, for abdominal pain and nausea. C- reactive protein was elevated in all patients, renal and hepatic functions were not impaired in any patients. Of the 15 patients, 9 patients had partial response, 4 had stable disease & 2 had complete response. The global physical score deteriorated slightly after 1st PIPAC (from 84% to 71%), but improved after PIPAC # 2 (up to 88%). Gastrointestinal symptoms & pain score remained stable under PIPAC therapy.

Conclusions Our results show the feasibility and safety of PIPAC for patients with advanced ovarian cancer. The procedure has low morbidity with no mortality & short learning curve. There was no therapy related deterioration of quality of life after PIPAC.

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