Peritoneal carcinosis

Absence of ascites may not exclude a malignant disease, as 50% of borderline tumors and 83% of early-stage ovarian cancers are not associated with ascites [4]. Peritoneal carcinosis is characterized by various amounts of ascites and difiuse or focal peritoneal thickening. Benign forms of ascites displaying the same pattern such as postoperative inflammatory changes, bacterial peritonitis, or chronic hemodialysis cannot be differentiated from peritoneal carcinosis... 

Due to rapid tumor progression peritoneal carcinosis is combined with a fast deterioration in general condition. This makes clinicians abandon further aggressive treatments. Recently, a curative approach appropriate for selected patients has been reported in the peer-reviewed literature. This treatment calls for the complete removal of all visible cancer from the abdomen and pelvis followed by intraopera-tively given intraperitoneal chemotherapy. The aim of this therapeutic endeavor is to eliminate macroscopic tumor formation by cytoreductive surgery and microscopic tumor remnants by intraoperative chemotherapy. 

The survival reported by numerous groups is comparable with that observed with other abdomi-nopelvic malignancy such as retroperitoneal and visceral sarcoma and liver metastases from colorectal cancer. The survival is far superior to that for some cancers that are routinely resected, such as pancreatic cancer, gallbladder cancer, and cholan-giocarcinoma. By analogy with other standard of practice management plans, the efficacy of these peritoneal carcinosis treatments and the morbidity and mortality are acceptable. 

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