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Purpose of Review <p>Peritoneal carcinomatosis (PC) represents a complex manifestation of intra-abdominal malignancies. Its resistance to systemic therapy and diagnostic challenges has limited treatment options and resulted in poor survival outcomes. This review synthesizes current evidence on the pathophysiology, diagnosis, patient selection, surgical techniques, outcomes, and emerging therapies in PC.</p> Recent Findings <p>Advances in the understanding of peritoneal tumor biology, coupled with the development of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), have significantly transformed the management landscape, enabling carefully selected patients to achieve meaningful survival outcomes. The diagnostic work-up has evolved to incorporate multimodal imaging, laparoscopy, serum and peritoneal biomarkers, and standardized scoring systems such as the Peritoneal Cancer Index (PCI) and Completeness of Cytoreduction (CC) score, which guide patient selection and surgical planning. Experimental approaches such as intraperitoneal immunotherapy, targeted therapies, nanoparticle drug delivery, and mucolytics are being actively investigated to expand treatment options for patients with unresectable or high-burden disease. Despite these advances, challenges persist, including heterogeneity in HIPEC protocols, and limited tumor-specific evidence.</p> Summary <p>Peritoneal carcinomatosis is no longer universally considered a terminal condition, with CRS and HIPEC offering significant survival benefit in appropriately selected patients. However, outcomes remain highly dependent on tumor biology, disease burden, and completeness of cytoreduction. Future progress will require improved patient selection, standardization of HIPEC protocols, and integration of emerging therapies.</p>

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Peritoneal Carcinomatosis: Evolving Paradigms in Diagnosis and Management

  • 期刊论文

  • 发表日期：

    2026年5月11日

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  • Sophia Okeke,
  • Erin Strong,
  • Alexandra Istl,
  • Nadege Fackche,
  • Juliet Lumati

摘要

Purpose of Review

Peritoneal carcinomatosis (PC) represents a complex manifestation of intra-abdominal malignancies. Its resistance to systemic therapy and diagnostic challenges has limited treatment options and resulted in poor survival outcomes. This review synthesizes current evidence on the pathophysiology, diagnosis, patient selection, surgical techniques, outcomes, and emerging therapies in PC.

Recent Findings

Advances in the understanding of peritoneal tumor biology, coupled with the development of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), have significantly transformed the management landscape, enabling carefully selected patients to achieve meaningful survival outcomes. The diagnostic work-up has evolved to incorporate multimodal imaging, laparoscopy, serum and peritoneal biomarkers, and standardized scoring systems such as the Peritoneal Cancer Index (PCI) and Completeness of Cytoreduction (CC) score, which guide patient selection and surgical planning. Experimental approaches such as intraperitoneal immunotherapy, targeted therapies, nanoparticle drug delivery, and mucolytics are being actively investigated to expand treatment options for patients with unresectable or high-burden disease. Despite these advances, challenges persist, including heterogeneity in HIPEC protocols, and limited tumor-specific evidence.

Summary

Peritoneal carcinomatosis is no longer universally considered a terminal condition, with CRS and HIPEC offering significant survival benefit in appropriately selected patients. However, outcomes remain highly dependent on tumor biology, disease burden, and completeness of cytoreduction. Future progress will require improved patient selection, standardization of HIPEC protocols, and integration of emerging therapies.