Peritoneal Carcinomatosis: Feature of Dissemination a Review

Abstract

Peritoneal carcinomatosis is a common event that develops in the natural history of many neoplastic diseases, representing a major problem encountered in cancer, management. Peritoneal seedings are often associated with neoplastic ascites resulting in a source of significant discomfort to the patient. Considered in the past as a terminal condition, peritoneal carcinomatosis was approached during the last two decades as a curable disease. The introduction of cytoreductive surgery or peritonectomy in the treatment of peritoneal neoplastic diseases drastically changed the natural history of peritoneal carcinomatosis. Another technique that showed an important impact on disease control is intraperitoneal hyperthermic perfusion, one of the most fascinating treatments of peritoneal carcinomatosis that results in an impressive increase in overall survival and quality of life in treated patients with low morbidity. This review illustrates the modality of dissemination of peritoneal carcinomatosis in relation to the primary tumor site and grade of malignancy. Peritoneal carcinomatosis is a term used to define an advanced stage of many abdominal neoplastic diseases that differ in biologic aggressiveness and prognosis. The different presentation of peritoneal carcinomatosis in relation to a different primary tumor and different grade of malignancy strongly influences the potentially therapeutic radical approaches using new and advanced modalities like cytoreductive surgery and intraperitoneal hyperthermic perfusion.

Prospective study of peritoneal recurrence after curative surgery for gastric cancer

“…Peritoneal dissemination occurs through a number of mechanisms. Tumour cells spread across the peritoneal cavity before surgery when the tumour involves the entire thickness of the gastric wall, but leakage of tumour cells from lymphatic vessels sectioned at the time of surgery and iatrogenic dissemination caused by the operation itself are other potential causes 5,6 . The average survival rate after peritoneal recurrence is only about 6 months.…”

Peritoneal mesothelioma treated by induction chemotherapy, cytoreductive surgery, and intraperitoneal hyperthermic perfusion

“…A variety of treatment options have been proposed, alone or in combination, but most have failed to demonstrate a significant impact in terms of palliation or disease-free and overall survival. The mechanism of death is related to intraperitoneal progression and the disease remains in the abdominal cavity for most of its natural history [4]. This pattern of spread would seem to indicate the potential usefulness of selectively increasing drug concentration in the tumor-bearing area by direct intraperitoneal chemotherapy instillation [5].…”

Expression of human apolipoprotein(a) kringles in colon cancer cells suppresses angiogenesis‐dependent tumor growth and peritoneal dissemination

“…However, despite the significant curative potential, the risk of recurrence is still high. The most common sites for colon cancer recurrence are the resection site, greater omentum, and the peritoneal surfaces [18,19]. Recurrence at the peritoneal surface is reported in 10-20% of patients after curative colon cancer resection.…”