PERITONEAL CARCINOMATOSIS SECONDARY TO OVARIAN CANCER: PROGNOSTIC IMPACT, THERAPEUTIC APPROACHES, AND CLINICAL OUTCOMES – A SYSTEMATIC REVIEW

Abstract

Introduction: Peritoneal carcinomatosis represents the most common pattern of dissemination in advanced ovarian cancer and remains a major determinant of prognosis, treatment complexity, and survival outcomes. Despite advances in systemic therapy and surgical techniques, peritoneal involvement continues to be associated with high morbidity and mortality. The integration of cytoreductive surgery, systemic chemotherapy, and intraperitoneal strategies has reshaped the therapeutic landscape, yet optimal patient selection and timing of interventions remain debated.

 Objective: The main objective of this systematic review was to evaluate the prognostic impact of peritoneal carcinomatosis secondary to ovarian cancer. Secondary objectives included assessing the effectiveness of different therapeutic approaches, comparing surgical and nonsurgical strategies, analyzing clinical outcomes and survival metrics, and identifying factors associated with treatment response and disease progression.

 Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and the International Clinical Trials Registry Platform. Studies published within the last five years were prioritized, with extension up to ten years when necessary. Eligible studies included clinical trials and observational studies evaluating prognosis and treatment outcomes in ovarian cancer–related peritoneal carcinomatosis. Data were synthesized qualitatively with structured comparison of interventions and outcomes.

 Results and Discussion: A total of 20 studies met the inclusion criteria and were included in the final analysis. The evidence indicates that complete or near-complete cytoreduction remains the strongest prognostic factor for survival, while the role of hyperthermic intraperitoneal chemotherapy and novel systemic agents shows variable benefit depending on disease burden and patient selection. Emerging data support individualized, multidisciplinary strategies to optimize outcomes while minimizing treatment-related morbidity.

 Conclusion: Peritoneal carcinomatosis secondary to ovarian cancer continues to pose significant prognostic and therapeutic challenges. Current evidence supports aggressive yet carefully selected surgical approaches combined with tailored systemic therapy. Ongoing refinement of patient selection criteria and integration of emerging treatments are essential to improve long-term outcomes.