The abdominal and pelvic cavities together the peritoneal cavity.  Intraabdominal tumours breaking through their radial margins will shed tumour cells into the peritoneal cavity.  This is commonly seen in ovarian, colorectal, gastric and other abdominal cancers.  There are also some rare tumours like primary peritoneal cancers, peritoneal mesothelioma and pseudomyxoma peritonei.  In all of these, previously deemed incurable, we now have a surgical technique known as cytoreductive surgery and HIPEC where in correctly selected patients with no evidence of distant or visceral metastasis, we will attempt to remove all the peritoneal deposits (cytoreductive surgery) and follow up intraoperatively with high dose intraperitoneal chemotherapy delivered at 40 C (HIPEC) (Fig 1 and 2).  We pioneered this operation in Singapore more than 15 years ago.  Our results in a highly selected group of patients have shown good survival rates compared to historical controls (Fig 3).