Primary peritoneal cancer is an uncommon cancer of the abdominal lining that closely mirrors epithelial ovarian cancer in symptoms, spread, and treatment. Diagnosis relies on imaging, CA-125, and biopsy. Standard treatment is surgical cytoreduction followed by platinum-based chemotherapy. Maintenance therapies such as PARP inhibitors have become important for eligible patients, and options like HIPEC are under study. Prognosis varies by stage and residual disease; recurrence is common, so ongoing surveillance and genetic testing are recommended.

What primary peritoneal cancer is

Primary peritoneal carcinoma (PPC) is a cancer that arises from the lining of the abdomen (the peritoneum). It closely resembles epithelial ovarian cancer - especially high-grade serous carcinoma - in symptoms, pattern of spread, and biology. Because of this overlap, clinicians often manage PPC alongside ovarian and fallopian tube cancers.

How it's diagnosed

Symptoms are nonspecific: persistent abdominal bloating or swelling, early fullness while eating, abdominal pain or discomfort, and unintentional weight change (often from fluid, or ascites). Doctors use a combination of physical exam, imaging (usually CT), blood tests such as CA-125, and tissue biopsy - often obtained by laparoscopy - to confirm the diagnosis.

Genetic testing is important. Women with BRCA1/2 variants and other defects in homologous recombination are at increased risk for PPC, similar to ovarian cancer.

Standard treatment today

Treatment depends on how far the disease has spread and on the patient's fitness for surgery. The current backbone of care remains aggressive surgical cytoreduction (debulking) to remove as much tumor as possible, followed by platinum-based chemotherapy - most commonly carboplatin combined with paclitaxel.

Maintenance therapies have changed the landscape in the past decade. PARP inhibitors (for example, olaparib, niraparib, and rucaparib) are used as maintenance treatment after a response to platinum chemotherapy in many patients with ovarian-type cancers, and they are increasingly applied to PPC in eligible patients (for example, those with BRCA mutations or broader homologous recombination deficiency) .

Intraperitoneal approaches, including HIPEC (hyperthermic intraperitoneal chemotherapy) at the time of surgery, are used in selected centers and selected patients, but the benefit compared with standard approaches remains an area of active research 1.

Prognosis and follow-up

Prognosis varies widely and depends on stage at diagnosis, the amount of residual tumor after surgery, and tumor biology. PPC often responds to initial treatment but has a high risk of recurrence, so long-term surveillance with periodic exams, imaging, and CA-125 when helpful is standard.

Even after risk-reducing salpingo-oophorectomy (removal of ovaries and fallopian tubes), a small risk of developing primary peritoneal cancer remains - this is one reason genetic counseling and tailored follow-up matter.

Practical points

  • See a gynecologic oncologist for diagnosis and treatment planning.
  • Ask about genetic testing (BRCA and other genes) because results affect treatment options and family counseling.
  • Discuss maintenance strategies and clinical trials, which can offer newer targeted options.
If you or a loved one is facing this diagnosis, ask the care team for clear staging information, expected treatment sequence, and a plan for follow-up and symptom management.
  1. Confirm current regulatory approvals and labeled indications for PARP inhibitors specifically mentioning primary peritoneal carcinoma (versus ovarian/fallopian tube cancers).
  2. Review recent randomized trials and guidelines on HIPEC use for primary peritoneal/ovarian-type cancers to clarify which patient groups, if any, benefit.

FAQs about Primary Peritoneal Cancer

How is primary peritoneal cancer different from ovarian cancer?
Biologically and clinically it is very similar to epithelial ovarian cancer. The main difference is the origin: PPC arises from the peritoneal lining rather than the ovaries. Treatment and follow-up are generally the same.
What are the main treatments for primary peritoneal cancer?
The standard approach is maximal surgical cytoreduction (debulking) followed by platinum-based chemotherapy (carboplatin and paclitaxel). Many patients are offered maintenance therapy, such as PARP inhibitors, if they meet eligibility criteria.
Should I have genetic testing if diagnosed with PPC?
Yes. Testing for BRCA1/2 and other homologous recombination genes is recommended because results can influence treatment choices and inform family risk.
Can primary peritoneal cancer come back after treatment?
Yes. Recurrence is common. Follow-up with exams, imaging, and blood tests such as CA-125 (when helpful) is standard to detect recurrence early.
Does removing the ovaries prevent PPC?
Risk-reducing salpingo-oophorectomy lowers the risk of ovarian and fallopian tube cancer, but a small risk of primary peritoneal cancer remains. Ongoing surveillance is still important.

News about Primary Peritoneal Cancer

Mirvetuximab soravtansine approved to treat adult patients who have ovarian, fallopian tube or primary peritoneal cancer - GOV.UK [Visit Site | Read More]

Fertility-sparing surgery in primary peritoneal serous borderline tumor: a case report - Frontiers [Visit Site | Read More]

New Peritoneal Surface Malignancy Guidelines Aim to Improve Unity Among Oncologists - CancerNetwork [Visit Site | Read More]

Johnson & Johnson talc and cancer compensation claim - Consumer Voice [Visit Site | Read More]

FDA OKs Breakthrough Status for Sofetabart Mipitecan for Some Gynecologic Cancers - Cure Today [Visit Site | Read More]

Raludotatug Deruxtecan Granted Breakthrough Therapy Designation by U.S. FDA for Patients with CDH6 Expressing Platinum-Resistant Ovarian, Primary Peritoneal or Fallopian Tube Cancers Previously Treated with Bevacizumab - Business Wire [Visit Site | Read More]

PIPAC Reshapes Peritoneal Cancer Surgery Workflows and Outcomes: With Gregory J. Tiesi, MD, FACS, FSSO; Anthony Scholer, MD, FACS, FSSO; Benjamin Jon Golas, MD, FACS; and Eric Pletcher, MD - OncLive [Visit Site | Read More]

Survival rate for peritoneal cancer: Stages and screening - MedicalNewsToday [Visit Site | Read More]