PIPAC (Pressurized Intraperitoneal Chemotherapy)

peritoneal carcinomatosis

Peritoneal Carcinomatosis: A Detailed Analysis of the Effectiveness of PIPAC Therapy

Innovative Alternative in Peritoneal Cancer Treatment

About PIPAC therapy

PIPAC therapy, or pressurised intraperitoneal chemotherapy, is an innovative method of treating peritoneal cancer. Using a special device, this procedure allows chemotherapeutic agents to be administered directly into the peritoneal cavity. But what makes it different from the HIPEC procedure and how can it help patients? Let’s find out more about this promising therapy.

The difference between PIPAC and HIPEC

Although both procedures are based on intraperitoneal chemotherapy, there are significant differences between PIPAC and HIPEC therapy. The HIPEC procedure (hyperthermic intraperitoneal chemotherapy) involves the use of a fluid circulating in the intraperitoneal cavity. Instead, PIPAC uses a special device to spray chemotherapy into the same cavity. The major difference lies in the indications.

PIPAC is for patients who, at the time of diagnosis, are not candidates for surgical resection or HIPEC. This treatment often prepares for cytoreduction therapy and HIPEC or provides an improvement in the quality of life of patients who can no longer benefit from systemic chemotherapy. It is a solution for patients in advanced stages who have exhausted other therapeutic options.

PIPAC Therapy in Evolution

PIPAC is an emerging procedure and oncology research is focusing on this chemo-pressurised therapy. So far, there is no defined standard for the procedure and the guidelines are still under debate. According to the latest international consensus, a minimum of three PIPAC sessions is recommended, depending on the patient’s response.

An important indicator is the presence of malignant ascites, which may be caused by peritoneal carcinomatosis. If ascites disappears after treatment with PIPAC chemotherapy, it can be considered a therapeutic success, even if it has a palliative approach. Therapy can be a solution to improve the quality of life of patients in this situation.

Advantages and Limitations

PIPAC has advantages and limitations. Ideally, the procedure should be performed by minimally invasive methods, using laparoscopic trocars to make small punctures in the abdominal wall. This allows chemotherapy to be administered directly to the tumours and ensures a rapid recovery of the patient, generally requiring only one night of hospitalisation. However, the procedure requires general anaesthesia.

PIPAC therapy is effective in treating peritoneal cancers such as colorectal, ovarian, gastric and retroperitoneal pseudomyxomas. This treatment represents hope for patients who are not candidates for cytoreduction and HIPEC or for those for whom these procedures are not possible.


PIPAC therapy is an innovative approach to the treatment of peritoneal cancer. Although it is still evolving, this procedure offers hope to patients who have no other therapeutic options. By delivering chemotherapy directly into the peritoneal cavity, PIPAC can improve patients’ quality of life and convert patients from inoperability to operability, giving them a chance of survival. It is important for patients and doctors to discuss this option and decide together whether PIPAC therapy is appropriate for each individual case.

peritoneal carcinomatosis