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World J Gastrointest Oncol. Jan 15, 2010; 2(1): 12-18
Published online Jan 15, 2010. doi: 10.4251/wjgo.v2.i1.12
Pathophysiology and biology of peritoneal carcinomatosis
Shigeki Kusamura, Dario Baratti, Nadia Zaffaroni, Raffaella Villa, Barbara Laterza, Maria Rosaria Balestra, Marcello Deraco
Shigeki Kusamura, Dario Baratti, Barbara Laterza, Maria Rosaria Balestra, Marcello Deraco, Department of Surgery, National Cancer Institute of Milan, Via Venezian 1, 20133 Milano, Italy
Nadia Zaffaroni, Raffaella Villa, Department of Experimental Oncology, National Cancer Institute of Milan, 20133 Milano, Italy
Author contributions: Kusamura S, Baratti D, Zaffaroni N and Villa R were responsible for the conception, design and writing of the manuscript; Laterza B, Balestra MR and Deraco M were responsible for the writing and final critical revision.
Correspondence to: Marcello Deraco, MD, Department of Surgery, National Cancer Institute of Milan, Via Venezian 1, 20133 Milano, Italy.
Telephone: +39-2-23902362 Fax: +39-2-23902404
Received: July 31, 2009
Revised: October 7, 2009
Accepted: October 14, 2009
Published online: January 15, 2010

Peritoneal carcinomatosis represents a devastating form of cancer progression with a very poor prognosis. Its complex pathogenesis is represented by a dynamic process comprising several steps. To the best of our knowledge pathogenesis can be partly explained by 3 major molecular pathways: (1) dissemination from the primary tumor; (2) primary tumor of peritoneum; and (3) independent origins of the primary tumor and peritoneal implants. These are not mutually exclusive and combinations of different mechanisms could occur inside a single case. There are still several aspects which need explanation by future studies. A comprehensive understanding of molecular events involved in peritoneal carcinomatosis is of paramount importance and should be systematically pursued not only to identify novel strategies for the prevention of the condition, but also to obtain therapeutic advances, through the identification of surrogate markers of prognosis and development of future molecular targeted therapies.

Keywords: Pathophysiology, Peritoneal carcinomatosis, Peritoneal mesothelioma, Pseudomyxoma peritonei, Ovarian cancer, Gastric and colorectal cancer