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Peritoneal metastases (PM) from colorectal cancer (CRC) still represent a huge health-care problem. Recent population-based studies report an overall 3.5–4.2% incidence of CRC-PM after potentially curative primary surgery [1,2]. These rates can reach up to about 25% in locally advanced CRC penetrating visceral peritoneum (pT4a), or directly infiltrating surrounding organs (pT4b) [[1], [2], [3]]. Accordingly, the peritoneum is one of the most common site of metastatic spread for CRC, following the liver and lung, even though incidences may be likely underestimated because PM are more difficult to detect than liver or lung metastases. A strategy involving local-regionally delivered chemotherapy to prevent the outgrowth of occult peritoneal seeding into macroscopic metastases is supported by a strong rationale: first, cytoreductve surgery (CRS) combined with hyperthermic intraperitoneal chemotheray (HIPEC) improve CRC-PM survival, but most patients are not suitable for this demanding treatment due to extensive peritoneal involvement, systemic metastases, and/or poor clinical conditions. Second, CRS/HIPEC is maximally effective and safe when small-volume disease is treated. Third, in the palliative setting, modern systemic chemotherapy (s-CT) and targeted agents appear to be less effective for peritoneal metastatic CRC than non-peritoneal metastatic CRC. Finally, the absence of symptoms, as well as current limitations of imaging, hamper early diagnosis and treatment [3]. On these bases, the use of HIPEC for the prevention or early treatment of CRC-PM has been tested at different time-points, either simultaneously with primary surgery [[3], [4], [5]], at the time of second-look surgery after adjuvant s-CT [6], or as a staged procedure at 5–8 weeks postoperatively [7]. Since we were amongst the first groups to investigate the role of adjuvant HIPEC, we were surprised to read that in the COLOPEC randomized trial such a treatment approach failed to demonstrate improved peri

Ovarian cancer (OC) remains relatively rare, although it is among the top 4 causes of cancer death for women younger than 50. The aggressive nature of the disease and its often late diagnosis with peritoneal involvement have an impact on prognosis. The current scientific literature presents ambiguous or uncertain indications for management of peritoneal carcinosis (PC) from OC, both owing to the lack of sufficient scientific data and their heterogeneity or lack of consistency. Therefore, the Italian Society of Surgical Oncology (SICO), the Italian Society of Obstetrics and Gynaecology, the Italian Association of Hospital Obstetricians and Gynaecologists, and the Italian Association of Medical Oncology conducted a multidisciplinary consensus conference (CC) on management of advanced OC presenting with PC during the SICO annual meeting in Naples Italy, on September 10-11, 2015. An expert committee developed questions on diagnosis and staging work-up, indications, and procedural aspects for peritonectomy, systemic chemotherapy, and hyperthermic intraperitoneal chemotherapy for PC from OC. These questions were provided to 6 invited speakers who answered with an evidence-based report. Each report was submitted to a jury panel, representative of Italian experts in the fields of surgical oncology, gynecology, and medical oncology. The jury panel revised the reports before and after the open discussion during the CC. This article is the final document containing the clinical evidence reports and statements, revised and approved by all the authors before submission.