Peritoneal carcinosis has historically been considered as inoperable, although the
technique of its resesection together with high dose intraperitoneal chemotherapy
potentiated by heat has been described decades ago. It has not became a widely practiced
routine except in specialized centers - the complex technique, weakly standardized
but resource demanding chemotherapy, lacking financial background and the many times
questionable clinical benefit at a cost of high surgical load might have been the
key factors. Refined technology, developing chemotherapy protocols together with growing
clinical evidence are now more sharply delineating the range of indications where
the procedure might be beneficial, increases survival, or is the only curative therapy.
These include tumors of the appendix and pseudomyxoma peritonei, mesothelioma, and
selected cases of ovarian, colorectal and gastric cancer. In addition to technical
description of the intervention, we summarize the currently valid indications and
describe our institutional protocol for the treatment of appendiceal malignancies.
