Prophylactic cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) offers significantly improved survival for patients with perforated appendiceal adenocarcinoma.

• Five-year overall survival with prophylactic CRS + HIPEC was 96.9% vs. 51.9% for conventional carcinologic resection.
• Five-year disease-free survival was 75.2% with prophylactic treatment compared to 34.3% in the standard group.

This approach should be a standard discussion point for surgical teams handling perforated appendiceal tumors.

• Postoperative morbidity rates were similar across all treatment groups, indicating safety in expanding surgical options.