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Life sciences · Journal article
International Journal of Health Management Review · October 21, 2026
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Peritoneal carcinomatosis, associated with gastric cancer and other gastrointestinal and gynecological neoplasms, is a highly complex advanced manifestation characterized by a high rate of morbidity and mortality, resistance to conventional therapies, and an unfavorable prognosis. The limitations of noninvasive radiological methods in identifying small-volume peritoneal implants make accurate diagnosis and staging key challenges in treatment planning. In this context, staging laparoscopy with peritoneal cytology, combined with assessment of disease extent using the Peritoneal Cancer Index (PCI), has emerged as a key factor in selecting patients eligible for curative or prolonged control strategies. This study aims to synthesize the current evidence regarding diagnostic challenges and multimodal therapeutic approaches in the management of peritoneal metastases, with an emphasis on the role of intraperitoneal chemotherapy and conversion surgery. A narrative literature review was conducted in the PubMed database using the search terms “Peritoneal Neoplasms” and “Therapeutics” with the Boolean operators AND and OR, covering phase III randomized clinical trials, systematic reviews, prospective cohorts, and international guidelines. The findings indicate that the management of peritoneal carcinomatosis has undergone substantial evolution. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is well-established for pseudomyxoma and peritoneal mesothelioma, but remains controversial for recurrent colorectal, gastric, and ovarian tumors. At the same time, innovative modalities, such as normothermic intraperitoneal and systemic therapy (NIPS) with paclitaxel—whose phase III data (the DRAGON-01 trial) demonstrated a significant improvement in overall survival and progression-free survival— pressurized intraperitoneal aerosol chemotherapy (PIPAC), and biomarker-guided therapies are expanding the available therapeutic options. It is concluded that the treatment of peritoneal carcinomatosis should be individualized and multidisciplinary, taking into account the tumor origin, disease burden, and clinical response. Although gaps remain in the literature regarding the validation of these approaches in Western populations, the consolidation of intraperitoneal therapies and rigorous patient selection represent a promising advance in disease control and the improvement of oncological outcomes.