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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\u2014specifically hyperthermic intraperitoneal chemotherapy\u2014with 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.<\/jats:p>","DOI":"10.3322\/caac.21749","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T08:59:03Z","timestamp":1660553943000},"page":"49-71","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":74,"title":["The contemporary management of peritoneal metastasis: A journey from the cold past of treatment futility to a warm present and a bright future"],"prefix":"10.3322","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0349-1661","authenticated-orcid":false,"given":"Jason M.","family":"Foster","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6622-3958","authenticated-orcid":false,"given":"Chunmeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahyan","family":"Rehman","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology Rutgers Cancer Institute of New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prateek","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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