Define peritoneal carcinomatosis.
a terminal feature of abdominal cancers (most commonly of the ovary, appendix, or colon) characterized by seeding of the tumor to the peritoneum
Describe the epidemiology.
depends on underlying malignancy; peritoneal carcinomatosis develops in ∼ 10% of individuals with colorectal cancer
Describe the etiology.
primary tumor metastasizes to the peritoneal surface
List clinical features.
Ascites
Fistulas
Fatigue
Abdominal pain, nausea, cachexia
Which diagnostic test is preferred?
CT is preferred; typically shows metastatic studding (tumor nodules studding the surface of the peritoneum) and omental caking
Describe the treatment.
Operable disease: involves cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC), systemic chemotherapy, targeted therapy, and/or immune checkpoint inhibitors
Inoperable disease: experimental pressurized intraperitoneal aerosolized chemotherapy or repeated intraperitoneal chemotherapy infusion
What are complications and what is the prognosis?
Complications: bowel, biliary, and/or ureteral obstruction
Prognosis: poor; 5-year survival rates after CRS and HIPEC are approx. 40%
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