The Clinical Desire for Pressurized Intraperitoneal Aerosol Chemotherapy in South Korea: An Electronic Survey-based Study.

Seung-Hyuk Shim,Eun Ji Lee,Suk-Joon Chang,Haerin Paik,Junhwan Kim,Jaehee Mun,Jeesun Lee,Ga Won Yim,Aeran Seol,Soo Jin Park,Hee Seung Kim

doi:10.21873/anticanres.15494

Abstract

To evaluate the clinical desire for pressurized intraperitoneal aerosol chemotherapy (PIPAC) in South Korea. We performed an online survey on surgical oncologists between November and December 2019 using a questionnaire consisting of 20 questions. A total of 164 respondents answered the questionnaire. Among those specialized in ovarian cancer, pseudomyxoma peritonei, and malignant mesothelioma 41.7-50% preferred PIPAC for the curative treatment of primary diseases, whereas 32.7-33.3% majoring in colorectal and hepatobiliary cancers chose it for the palliative treatment of recurrent diseases. Furthermore, 66.7-95.2% considered PIPAC appropriate for the cancers they specialized in, and 76-78.7% expected a treatment response of more than 50% and considered grade 1 or 2 complications acceptable. Most respondents answered the reasonable costs to purchase and implement PIPAC once at between 1,000,000-5,000,000 South Korean Won (KRW). Most Korean surgical oncologists expected relatively high tumor response rates with minor toxicities through the repeated implementation of PIPAC.

Highlights

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is effective for treating peritoneal metastasis
41.7-50% majoring in ovarian cancer, pseudomyxoma peritonei, and malignant mesothelioma preferred pressurized intraperitoneal aerosol chemotherapy (PIPAC) for the curative treatment of primary diseases, whereas 32.7-33.3% majoring in colorectal and hepatobiliary cancers chose it for the palliative treatment of recurrent diseases
Most of the respondents answered the reasonable costs to purchase and implement PIPAC once at between 1,000,000-5,000,000 KRW. This surgery may reflect on the availability, scope, and reasonable cost of PIPAC treatment in South Korea for introducing PIPAC

Summary

Introduction

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is effective for treating peritoneal metastasis. It is currently used in the limited areas. Peritoneal metastasis (PM) is commonly accompanied by a variety of solid tumors showing drug resistance to intravenous (IV) chemotherapy, which leads to a poor prognosis [1,2,3]. On the other hand, pressurized intraperitoneal aerosol chemotherapy (PIPAC) delivers chemotherapeutic agents as an aerosol formed by a high-pressure injector at room temperature. PIPAC can be conducted repeatedly with more diffuse distribution, deeper penetration, and fewer toxicities than IP chemotherapy and HIPEC [10, 11]. PIPAC is currently considered primarily a palliative treatment [12] and is only available in the limited areas including European countries and Singapore [13]

Methods

Results

Conclusion