Preliminary experience with locoregional intraarterial chemotherapy of uterine cervical or endometrial cancer using the peripheral implantable port system (PIPS): a feasibility study

The purpose of this study was to assess the suitability of a percutaneously implantable catheter port system (PIPS) for repeated intraarterial locoregional chemotherapy (ILC) for cervical and endometrial carcinoma. In 30 patients with advanced, recurrent, or high-risk cervical (n = 23) or endometrial (n = 7) carcinoma, PIPS for ILC was implanted via a femoral access, the catheter localized in the infrarenal abdominal aorta. Chemotherapy was performed adjuvantly after surgery (n = 14) or neo-adjuvantly to enable surgery, or for palliation (n = 16). Port implantation, catheter placement, and repeated port puncture was uneventful in all patients. Complications included catheter dislocation (n = 1), catheter thrombosis (n = 2), subcutaneous infection (n = 1), port-bed skin atrophy (n = 1), requiring port explantation in 3 patients. At 2 years follow-up, complete remission was observed in 7/14 patients with adjuvant chemotherapy, partial remission in 3/14. Successful down-staging could be achieved in 4/8 patients with neo-adjuvant chemotherapy. The PIPS is suitable for repeated ILC which may be a valuable method for pre- and post-surgical therapy of advanced or high-risk cervical and endometrial cancer, for adjuvant chemotherapy as well as neo-adjuvantly for down-staging, or for palliation.