CURRENT THERAPEUTIC APPROACHES IN THE TREATMENT OF PERITONEAL CARCINOMATOSIS
TL;DR
In gastric cancer with peritoneal metastasis, normothermic intraperitoneal chemotherapy (NIPS) combined with systemic treatment has demonstrated improved overall survival and higher rates of negative cytology conversion.
Abstract
Peritoneal carcinomatosis (PC) is a neoplastic spread associated with various primary tumors, with a prognosis that varies according to the origin and extent of the disease. This narrative review summarizes current therapeutic approaches, indications, and limitations, based on articles indexed in PubMed over the last five years. Management depends on the tumor origin, extent of disease (Peritoneal Cancer Index - PCI), feasibility of complete cytoreduction, and the patient's clinical status. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is an established treatment for pseudomyxoma peritonei and peritoneal mesothelioma but remains controversial for colorectal and gastric malignancies. In gastric cancer with peritoneal metastasis, normothermic intraperitoneal chemotherapy (NIPS) combined with systemic treatment has demonstrated improved overall survival and higher rates of negative cytology conversion. In platinum-resistant ovarian cancer with high FRα expression, mirvetuximab soravtansine showed survival benefits and objective response rates superior to conventional chemotherapy. Treatment must be individualized, and further evidence is essential to define optimized strategies integrating surgery, intraperitoneal therapies, and immunotherapy.