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Peritoneal metastasis occurs in a number of heterogeneous tumors originating from the ovaries, stomach, intestines, pancreas, lungs, breast, and melanoma. Peritoneal carcinomatosis significantly reduces overall survival. While being almost unresponsive to treatment, dissemination of tumor cells along the peritoneum aggravates the course of the disease. Despite the use of locoregional treatment, peritoneal carcinomatosis is still considered to be an aggravating factor with a poor prognosis. Peritoneal carcinomatosis cannot be defined as a separate locoregional process with its own biology and oncogenesis due to the lack of clear understanding the molecular and biological features of peritoneal metastasis, as well as generally recognized standards for diagnosis and treatment of malignant neoplasms with various localizations. Addressing peritoneal carcinomatosis as a separate developing molecular event will enhance the understanding of its morpho- and oncogenesis and strengthen the search for therapeutic, diagnostic and preventive approaches to its management. Th e paper presents a bibliographic study of publications on exploring peritoneal metastases from various sites, including the abdominal and pelvic organs. Th e known mechanisms of tumors metastasis to the peritoneum are characterized in the paper. Diagnostic approaches to peritoneal carcinomatosis were assessed and compared. Th e collected data analysis revealed the main gaps in the understanding of peritoneal carcinomatosis oncogenesis.

Peritoneal carcinomatosis is viewed by many experts as a terminal illness with an unfavourable course and prognosis. Existing therapies are controversial and exhibit ambiguous efficacy. We review the current state of the art in therapy for peritoneal metastases of various origin and its historical background. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy compound the treatment of choice as achieving the highest survival rates. Palliative surgery and systemic chemotherapy are an alternative that proved even more aggressive and ineffective in comparative survival evaluations. Manifold studies and expert opinions exist on the efficacy and expedience of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in treatment of peritoneal carcinomatosis. Today, however, their routine use in everyday practice is hotly debated. Despite an evident progress in managing peritoneal metastases, a series of questions remain unsolved. Contentious research data, late diagnosis, low treatment efficacy in severe peritoneal dissemination, a limited applicability of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, all highlight the importance of inventing and developing novel methods for early high-accuracy diagnosis and careful selection of the treatment strategy. Fundamental knowledge of malignant metastasis underlies the choice of patient management and the innovative toolkit for prevention and treatment of peritoneal carcinomatosis.