腹腔转移（PM）通常被认为是一种较少见的扩散方式。然而，从所有原发肿瘤的各个光谱中来看，PM的后果每年影响了大量患者。与其他转移方式不同，出现症状或治疗过程中的症状很常见，这对PM的治疗构成了额外的挑战。早期化疗和不完全手术介入虽然短暂地改善了症状，但持久的症状控制和生存期延长是很少见的，这在20世纪的大部分时间里形成了PM治疗无效的观点。值得注意的是，更好的系统疗法组合的持续发展、细胞减少性手术（CRS）的优化以及与CRS结合局部疗法，特别是热化学腹腔灌注化疗，的严格研究已经为PM患者提供了更有效的综合治疗选择。在本文中，作者全面回顾了建立现代方法治疗高频PM肿瘤的数据，包括阑尾、结肠直肠、胸膜和胃癌。作者还探讨了将热化学腹腔灌注化疗添加到为晚期卵巢癌进行CRS和系统疗法的成熟模式中的新兴角色，以及最近的临床试验确定了聚腺苷酸二磷酸核糖酰化酶维持治疗的有效性。最后，还包括了探索PM管理中精准医学技术的作用的最新数据，这在未来可能有助于进一步改善患者选择、确定最佳的系统疗法方案、检测可操作的突变并为药物开发寻找新靶点。 © 2022 The Authors. CA：A Cancer Journal for Clinicians 由Wiley Periodicals LLC代表美国癌症协会出版。

Peritoneal metastasis (PM) is often regarded as a less frequent pattern of spread; however, collectively across all spectra of primary tumors, the consequences of PM impact a large population of patients annually. Unlike other modes of metastasis, symptoms at presentation or during the treatment course are common, representing an additional challenge in the management of PM. Early efforts with chemotherapy and incomplete surgical interventions transiently improved symptoms, but durable symptom control and survival extension were rare, which established a perspective of treatment futility for PM through most of the 20th century. Notably, the continued development of better systemic therapy combinations, optimization of cytoreductive surgery (CRS), and rigorous investigation of combining regional therapy-specifically hyperthermic intraperitoneal chemotherapy-with CRS, have resulted in more effective multimodal treatment options for patients with PM. In this article, the authors provide a comprehensive review of the data establishing the contemporary approach for tumors with a high frequency of PM, including appendix, colorectal, mesothelioma, and gastric cancers. The authors also explore the emerging role of adding hyperthermic intraperitoneal chemotherapy to the well established paradigm of CRS and systemic therapy for advanced ovarian cancer, as well as the recent clinical trials identifying the efficacy of poly(adenosine diphosphate ribose) polymerase maintenance therapy. Finally, recent data are included that explore the role of precision medicine technology in PM management that, in the future, may help further improve patient selection, identify the best systemic therapy regimens, detect actionable mutations, and identify new targets for drug development.© 2022 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.