Primary peritoneal cancer (PPC) originates in the peritoneum, the tissue that covers organs in the abdomen and lines the wall of the abdomen, rather than spreading to the peritoneum from another area.

Peritoneal cancer sometimes spreads to the ovary. It is similar to ovarian epithelial cancer.

This article looks at what PPC is and its symptoms, diagnosis, treatment, and more.

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PPC is a type of cancer that starts in the peritoneal cavity in the abdomen, rather than cancer that has developed elsewhere in the body and spread to the peritoneum.

Cancer that has started elsewhere and spread to the peritoneum is called secondary peritoneal cancer.

Peritoneal cancer invades the serous membrane lining and organs of the peritoneal cavity.

PPC is rare, and is more common in females.

Mutations in the BRCA gene can cause increased susceptibility to ovarian, pancreatic, breast, and peritoneal cancers.

People with familial breast cancer may be at higher risk of peritoneal cancer.

Asbestos exposure may also cause one type of peritoneal cancer, malignant peritoneal mesothelioma, especially in males 60 years and older.

Secondary peritoneal cancer is more common than PPC and refers to cancer that has spread to the peritoneum from another part of the body.

Cancer cells that cause secondary peritoneal cancer usually spread from tumors located in the:

People often do not recognize symptoms of peritoneal cancer, which may lead to a delayed diagnosis.

Because of this, many people have widespread, late-stage cancer by the time a doctor diagnoses the disease.

The symptoms of PPC may include:

To diagnose and stage peritoneal cancer, a doctor may ask questions about the patient’s medical history.

They may also use:

Doctors will usually perform the biopsy at the same time as surgery to remove the tumor.

Treatment for PPC usually involves surgery, chemotherapy, and targeted therapy. Doctors treat PPC the same way as ovarian epithelial cancer.


In most cases, doctors try to remove as much of the tumor as possible through surgery.

There are different surgery options available, which can depend on the patient’s physiology, the extent of their cancer, and other factors.

Types of surgery include:

  • Omentectomy: In this surgery, surgeons remove the omentum, which is tissue in the peritoneum that contains lymph nodes, lymph vessels, nerves, and blood vessels.
  • Lymph node biopsy: In this surgery, surgeons remove part or all of a lymph node for a pathologist to examine for cancer cells.
  • Hysterectomy: This involves surgeons removing the uterus and sometimes the cervix. A hysterectomy can be:
    • Partial: surgeons remove only the uterus
    • Total: surgeons remove the uterus and cervix
    • Vaginal: surgeons remove the uterus and cervix through the vagina
    • Total abdominal: surgeons remove the uterus and cervix through a large incision in the abdomen
    • Total laparoscopic: surgeons remove the uterus and cervix through a small incision in the abdomen
  • Unilateral salpingo-oophorectomy: This involves surgeons removing one fallopian tube and one ovary.
  • Bilateral salpingo-oophorectomy: In this surgery, surgeons remove both fallopian tubes and both ovaries.


Doctors often use intraperitoneal chemotherapy to treat primary peritoneal and ovarian cancer.

In this treatment, a thin tube carries the chemotherapy drugs directly into the peritoneal cavity.

Doctors may also use hyperthermic intraperitoneal chemotherapy to treat peritoneal cancer.

This involves warmed chemotherapy drugs, which a thin tube carries into the peritoneum.

Targeted therapy

In targeted therapy, doctors use drugs or other substances to identify and attack only specific cancer cells.

The drugs typically contain antibodies that can attach to cancer cells and damage or kill them or prevent them from growing.

Doctors typically consider the outlook for PPC to be poor, and often terminal.

The survival rate of cancer varies depending on the location of the tumor. Survival rates are as follows for tumors in specific locations of the peritoneum:

  • pancreatic area: 2.9 months
  • gastric area: 6.5 months
  • colorectal area: 6.9 months

This section answers some frequently asked questions about PPC.

How do you get primary peritoneal cancer?

Some people may be at higher risk of developing PPC than others. These include people who have:

  • a mutated BRCA 1 gene
  • a family history of breast cancer
  • been exposed to asbestos
  • have high levels of estrogen during menopause

How long can you live with primary peritoneal cancer?

The survival rate of PPC depends on the location and extent of the cancer, as well as factors such as a person’s age and overall health.

On average, people with this cancer survive between 2 and 17 months.

Is primary peritoneal cancer curable?

Whether doctors can cure PPC depends on several factors, such as the stage of the cancer, the patient’s age, whether the tumor is well-differentiated, and many others.

The outlook for this cancer is typically poor.

PPC is rare cancer that originates in the peritoneum in the abdomen.

Secondary peritoneal cancer, which originates elsewhere in the body and spreads to the peritoneum, is more common.

PPC is usually widespread at the time of diagnosis, which results in a generally poor outlook for the disease.

Treatment typically involves surgery to remove the tumor, chemotherapy, and targeted therapy.