Disturbance in hemostatic physiology related to extensive surgery and HIPEC can be caused by a combination of factors including: hemodilution, tumor burden effect, consumption lysis, significant protein losses which, alongside with albumin diffusion into extravascular spaces, blood loss, early activation of protein C and FX, direct effect of intra-peritoneal chemotherapy and hyperthermia which all potentially account for the early impact on coagulation. This evidence concerns the gene ALB and neoplasm.