Peritoneal carcinomatosis: Anatomy, physiology, diagnosis, management

Summary The complex anatomy and physiology of the peritoneal mesothelium, the rarity of primary tumors of the peritoneum, and the high mortality associated with secondary tumor involvement are all factors that make management of peritoneal neoplasms unique and challenging. With an improved understanding of the gross and histologic anatomy, fluid kinetics, and peritoneal physiology, surgical hyperthermic and chemotherapeutic advances have been made. Collective, controlled clinical trials with many investigators will be necessary to accumulate sufficient data to test hypotheses concerning optimal management of the rare tumors, pseudomyxoma peritonei, and peritoneal mesothelioma. With improved understanding of peritoneal carcinomatosis and the pathophysiology 32,64 of malignant ascites, efforts toward further advances in palliative, and potentially curative, theraoy are specifically directed.