Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in Gastric Cancer
Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in Gastric Cancer
Maulana Azad Medical College, Delhi, GB Pant Hospital, Delhi
Holds the highest degrees in Oncology - DrNB, MCh
Having 15+ years of experience in treating
11750+ Patients have been successfully
treated
15+ years of work experience as a liver cancer specialist
22+ Awards received by Dr. Shah for his achievements
CRS+HIPEC refers to the combination of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy, a specialized treatment used primarily for cancers located in the peritoneal cavity. This approach includes two components: CRS, where surgeons excise visible tumors, and HIPEC, which involves administering warm chemotherapy directly into the abdomen.
Benefits of CRS+HIPEC over Traditional Treatments
CRS+HIPEC, which combines Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy, presents notable benefits compared to conventional treatment methods:
1. It leads to higher survival rates, particularly effective for cancers within the peritoneal cavity.
2. Offers better local management by directly addressing tumor sites.
3. Minimizes overall toxicity in the body and results in reduced adverse effects.
4. Provides new avenues for treating cancers that were previously difficult to manage.
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CRS+HIPEC has demonstrated encouraging outcomes in treating a range of cancers within the abdominal area. The following are some of the specific conditions where this advanced treatment method can be effectively applied:
Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in Gastric Cancer
HIPEC offers several advantages:
• Direct chemotherapy administration to the abdominal area.
• Enhanced chemotherapy efficacy due to heat application.
• Improved effectiveness in removing tumors during surgery.
• Lower chance of cancer returning.
• Possible increase in survival rates for certain advanced abdominal cancers.
Studies have shown that for certain cancers, CRS-HIPEC can significantly prolong survival compared to traditional treatments. For example, in cases of peritoneal mesothelioma, median survival rates can extend beyond 50 months with this treatment, compared to less than 12 months with traditional chemotherapy alone. In ovarian cancer, CRS-HIPEC has been shown to improve survival rates, particularly in patients with a small volume of disease.
Typically, patients can expect the following in terms of recovery:
1. Hospital Stay: Patients usually stay in the hospital for 7 to 14 days post-surgery. This duration can be longer if there are complications.
2. Initial Recovery: The first few weeks after discharge are often the most challenging. Patients may experience fatigue, discomfort, and limitations in physical activity. Complete healing from surgery may take several weeks.
3. Full Recovery: Full recovery can take anywhere from 6 weeks to a few months. During this period, patients gradually regain their strength and return to their normal activities. The timeline can vary based on the individual’s health status and the complexity of the surgery.
The survival rate for patients undergoing Cytoreductive Surgery (CRS) combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) depends on various factors including the type of cancer being treated, the stage of the disease, the patient’s overall health, and the completeness of the tumor removal during surgery.
Here are some general survival rate statistics for different types of cancers treated with CRS-HIPEC:
1. Peritoneal Mesothelioma: For patients with peritoneal mesothelioma, CRS-HIPEC has significantly improved survival rates. Median survival times of 40 to 92 months have been reported, which is a considerable improvement over traditional chemotherapy treatments.
2. Colorectal Cancer with Peritoneal Metastasis: In cases of colorectal cancer with peritoneal metastasis, the median survival with CRS-HIPEC treatment ranges from 30 to 63 months, compared to 12 to 24 months with systemic chemotherapy alone.
3. Ovarian Cancer: For advanced ovarian cancer, especially when the disease is limited to the peritoneal cavity, CRS-HIPEC has shown improved survival rates. Median survival times range from 30 to 45 months, which is higher compared to standard treatment.
4. Gastric Cancer with Peritoneal Spread: In gastric cancer with peritoneal dissemination, CRS-HIPEC can offer a median survival of about 12 to 31 months, a significant improvement over the median survival with systemic chemotherapy alone.
5. Pseudomyxoma Peritonei: This rare condition often responds well to CRS-HIPEC, with reported 5-year survival rates exceeding 80% in some studies.
Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a specialized treatment used primarily for cancers that have spread to the lining of the abdominal cavity, known as the peritoneum. The types of cancers that are commonly treated with HIPEC include:
1. Peritoneal Mesothelioma: A rare cancer that develops in the lining of the abdomen and is often associated with asbestos exposure.
2.Ovarian Cancer: HIPEC is used particularly in advanced stages where the cancer has spread within the abdominal cavity.
3. Colorectal Cancer: It’s used for colorectal cancer that has spread to the peritoneum, especially when the metastasis is limited to the abdominal cavity.
4. Gastric Cancer: In cases where gastric cancer has spread to the peritoneum, HIPEC can be considered as a treatment option.
5. Appendiceal Cancer: Including pseudomyxoma peritonei, a condition often associated with appendiceal tumors.
6. Other Gastrointestinal Cancers: Such as certain types of pancreatic, small bowel, and hepatobiliary cancers, in cases where they have metastasized to the peritoneum.
7. Primary Peritoneal Cancer: A rare cancer that originates in the peritoneum itself.
8. Selected Sarcomas: Including some cases of sarcoma that have spread to the peritoneal surface.
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