PIPAC has been used for gastric cancer with peritoneal metastases, usually combined with systemic chemotherapy, and in a minority of patients it has been followed by surgery, although its benefit remains under investigation.
Peritoneal spread is common and difficult to treat in stomach cancer, so PIPAC is a frequent focus of research. Outcomes depend on disease extent and how well the cancer responded to earlier treatment.
PIPAC with oxaliplatin may be considered for colorectal and appendiceal peritoneal metastases, particularly when disease has progressed on chemotherapy or is not suitable for cytoreductive surgery with HIPEC.
When peritoneal disease is limited and can be removed completely, cytoreductive surgery with HIPEC generally remains the established option at expert centers. PIPAC is usually considered for wider or recurrent disease.