Natural history of peritoneal carcinomatosis from nongynecologic malignancies

Both clinical experience and clinical research show that there is a limited survival, estimated to be approximately 6 months, in patients with peritoneal carcinomatosis from nongynecologic malignancy. Survival is shortest in patients with carcinomatosis from pancreas cancer, and is slightly more prolonged with colon cancer. The short survival is seen when the diagnosis of carcinomatosis is made synchronously with the primary cancer, and also when it is diagnosed in follow-up. A large diagnostic shortcoming is the inability to reliably diagnose carcinomatosis, either with the primary malignancy or with recurrent cancer. The Gilly carcinomatosis staging system has profound prognostic implications in this group of patients. The rapid progression of this disease state and the dependence of benefit upon complete cytoreduction suggests a need for early interventions in selected patients.