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Cancers
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Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in Cancer Therapy
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Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in Cancer Therapy

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 1358

Special Issue Editor

Dr. Andrea Di Giorgio

E-Mail Website
Guest Editor
Surgical Unit of Peritoneum and Retroperitoneum, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
Interests: gastrointestinal, colorectal, and pancreatic surgery; mini-invasive surgery; peritoneal metastasis; cytoreductive surgery; PIPAC; HIPEC

Special Issue Information

Dear Colleagues,

You are cordially invited to contribute to the Special Issue "Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) for Cancer Therapy".

Peritoneal metastases (PMs) are common in the advanced stages of many intra-abdominal malignancies. Unfortunately, treatment options for unresectable PMs are limited, and the standard treatment is palliative systemic chemotherapy, with unsatisfactory results.

PIPAC is an innovative treatment modality for unresectable peritoneal metastasis ensuring better distribution of the aerosol-chemotherapy into the abdominal cavity and deeper tissues and nodules drug penetration. Since its first description in 2011, PIPAC has proven to be a feasible and safe procedure. Due to its mini-invasive nature and safe profile, it seems a promising tool for implementing the comprehensive treatment of patients with peritoneal metastasis.

Ongoing research is exploring new drugs for intraperitoneal administration, the safety of combining use with systemic chemotherapy, and the efficacy of PIPAC compared with the standard treatment.

In this Special Issue, we aim to emphasize patient selection criteria, the treatment response assessment, the efficacy outcomes, the economic costs of the procedure, the pharmacokinetic results of the aerosol chemotherapy, and the emerging topic of PIPAC as neoadjuvant treatment.

Original research articles and reviews are welcome. 

We look forward to receiving your contributions.

Dr. Andrea Di Giorgio
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • PIPAC
  • intraperitoneal chemotherapy
  • aerosol chemotherapy
  • peritoneal metastasis
  • neoadjuvant
  • bidirectional treatment
  • patient selection
  • peritoneal carcinomatosis

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Published Papers (2 papers)

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Research

11 pages, 686 KiB  
Article
Predictive Factors for the Discontinuation of Pressurized Intraperitoneal Aerosol Chemotherapy: Enhancing Patient Selection to Improve Oncological Outcomes—A Single-Center Experience
by Matteo Aulicino, Francesco Santullo, Cecilia Orsini, Luca D’Agostino, Martin Hübner, Hugo Texeira-Farinha, Manuela Robella, Olivia Sgarbura, Agustìn Bianco, Almog Ben-Yaacov, Federica Ferracci, Giorgio D’Annibale, Fabio Pacelli and Andrea Di Giorgio
Cancers 2025, 17(2), 265; https://doi.org/10.3390/cancers17020265 (registering DOI) - 15 Jan 2025
Viewed by 108
Abstract
Background: Since 2011, Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) has emerged as a promising treatment option for patients with peritoneal surface malignancies (PSM) who are not eligible for cytoreductive surgery (CRS). Repeated minimal-invasive treatment is one of the key features and the current [...] Read more.
Background: Since 2011, Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) has emerged as a promising treatment option for patients with peritoneal surface malignancies (PSM) who are not eligible for cytoreductive surgery (CRS). Repeated minimal-invasive treatment is one of the key features and the current empirical standard treatment (ST) consists of at least three administrations over about three months. However, many patients are unable to complete the full course, limiting the potential benefits of PIPAC. Method: This retrospective, single-center study assessed the completion rate of ST and identified the main causes and predictive factors for discontinuation. This study also evaluated the feasibility, safety, and efficacy of PIPAC and investigated whether improved patient selection over the years has resulted in better oncological outcomes. Result: Data from 168 patients treated with PIPAC between January 2017 and March 2023 for a total of 336 procedures showed that only 29% completed ST. Multivariate analysis identified ascites >500 mL and a prior history of bowel obstruction as significant predictors of discontinuation. Conclusions: Patients with radiological or clinical signs of obstruction should not be considered for PIPAC treatment, and ascites increases the risk of incomplete treatment. Larger studies are eagerly awaited to corroborate these findings and refine the selection criteria by disease entity. Full article
(This article belongs to the Special Issue Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in Cancer Therapy)
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9 pages, 223 KiB  
Article
How to Implement Pressurized Intraperitoneal Aerosol Chemotherapy into a National Health System Scenario: A Single-Center Retrospective Analysis of Costs and Economic Sustainability at a High-Volume Italian Hospital
by Matteo Aulicino, Cecilia Orsini, Giorgio D’Annibale, Lorenzo Barberis, Paolo Catania, Carlo Abatini, Miriam Attalla El Halabieh, Federica Ferracci, Claudio Lodoli, Francesco Santullo, Fabio Pacelli and Andrea Di Giorgio
Cancers 2024, 16(15), 2637; https://doi.org/10.3390/cancers16152637 - 24 Jul 2024
Cited by 1 | Viewed by 1050
Abstract
PIPAC is a new surgical procedure and a viable treatment option for PSM patients, due to promising therapeutic outcomes, minimal invasiveness, limited surgical morbidity, and systemic toxicity side effects. However, its implementation throughout hospitals is hard to obtain due to its fragile economical [...] Read more.
PIPAC is a new surgical procedure and a viable treatment option for PSM patients, due to promising therapeutic outcomes, minimal invasiveness, limited surgical morbidity, and systemic toxicity side effects. However, its implementation throughout hospitals is hard to obtain due to its fragile economical sustainability. A retrospective health economic analysis was conducted in order to evaluate the cost of hospitalization for patients undergoing PIPAC treatment at Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, in Rome. The average cost of a PIPAC procedure was defined based on the cost of surgery (cost of surgical material, operating room, intraperitoneal chemotherapy), hospital stay, diagnostic examinations, and drugs used during the stay. A total of 493 PIPAC procedures were performed on 222 patients with peritoneal metastases or primary peritoneal cancer from 2017 to 2023. Since the mean remuneration for each PIPAC hospitalization is €5916 and the mean expenditure per hospitalization is €6538, this results in an operating profit per PIPAC hospitalization of −€622. The reimbursement of PIPAC treatment by the Italian National Health System currently only partially covers the hospital’s costs. Development of specific codes and adequate reimbursement for PIPAC by recognizing this procedure as a proper treatment for peritoneal carcinomatosis is essential. Full article
(This article belongs to the Special Issue Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in Cancer Therapy)
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