Carcinomatosis

Carcinomatosis is the spread of a tumor on the surfaces of the organs within the abdomen. The tumors may also spread to the lining of the abdomen which is termed the peritoneum. Because of this, sometimes carcinomatosis may be referred to as ‘peritoneal surface disease’. The tumor implants may either be discrete, small nodules or more similar to a sheet of tumor cells coating the organs.

Why some tumors or cancers lead to carcinomatosis is unknown. Carcinomatosis is more common with cancers of the colon or rectum, appendix, or ovaries. However, other malignancies may also spread in this manner and lead to carcinomatosis. Additionally, there are rare tumors that develop from the peritoneum.

In general, carcinomatosis is considered stage 4 disease for most cancers or tumors. However, there is a wide range of outcomes with carcinomatosis. Some cancers behave more aggressively and quickly spread throughout the abdomen, while others may grow slowly over months to years. The aggressiveness of the tumor can be partially predicted based on biopsies and knowledge of the source of carcinomatosis.

Patients with carcinomatosis may note increasing abdominal bloating or distension. They may develop cramping abdominal pains, particularly after eating. Carcinomatosis patients also may feel full quickly after eating or develop weight loss. Some patients with carcinomatosis have no symptoms and the condition is diagnosed during evaluation for other disorders or during routine imaging follow-up for a resected cancer.

The specific treatment regimen for patients with carcinomatosis requires close collaboration of a team of experts. Patients may be treated with chemotherapy or surgery or other procedures, depending on the exact nature and extent of their carcinomatosis.

Some patients are candidates for surgery for treating their carcinomatosis. The purpose of such surgery is to remove the vast majority of the tumor implants. This often requires removing involved organs such as portions of the small intestine or colon, the spleen, or the ovaries. An additional measure that may be recommended is the delivery of heated chemotherapy directly in to the abdomen during surgery; this is commonly referred to as HIPEC. The exact treatment plan is developed by the surgeon, the medical oncologist and the patient, and the plan is tailored based on other factors such as the cause of the carcinomatosis and other medical conditions.

Washington University Colorectal can provide treatment options for carcinomatosis. Meet our specialists below.