Abstract
Peritoneal surface malignancy (PSM) refers to spread of cancer on the parietal peritoneum, the omentum, and the serosal surface of intraabdominal viscera. It is not considered a form of systemic distant metastasis. It is formerly knowns as peritoneal carcinomatosis. Lesions most commonly associated with PSM include epithelial lesions of the appendix, colorectal cancer, ovarian cancer, gastric cancer, and diffuse malignant peritoneal mesothelioma. PSM may occur in 25% of cases of colorectal cancer, and 53%–60% of cases of gastric cancer. Patients with PSM may present with increasing abdominal girth, ascites, and hernia (umbilical, inguinal). In many cases, PSM is found serendipitously during planned surgery (e.g., colorectal resection for cancer) or urgent surgery (e.g., exploration for bowel obstruction or appendicitis). Quantitative assessment for tumor distribution throughout the peritoneal cavity is performed using the peritoneal carcinomatosis index (PCI). Operative treatment of PSM is comprised of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).
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