Annals of Surgical Oncology

, Volume 21, Issue 6, pp 1792–1800 | Cite as

Bevacizumab Doubles the Early Postoperative Complication Rate after Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Carcinomatosis of Colorectal Origin

  • Clarisse Eveno
  • Guillaume Passot
  • Diane Goéré
  • Philippe Soyer
  • Etienne Gayat
  • Olivier Glehen
  • Dominique Elias
  • Marc Pocard
Colorectal Cancer



Patients with stage IV colorectal cancer and peritoneal carcinomatosis are increasingly treated with curative intent and perioperative systemic chemotherapy combined with targeted therapy. The aim of this study was to analyze the potential impact of bevacizumab on early morbidity after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal carcinomatosis of colorectal origin.


From 2004 to 2010, in three referral centers, 182 patients with colorectal carcinomatosis were treated with complete cytoreduction followed by HIPEC after either preoperative systemic chemotherapy alone or in combination with bevacizumab. Because there was no control on treatment allocation, propensity score methods were used to control for this bias.


The median time from discontinuation of bevacizumab to HIPEC was 7 weeks (range 6–10 weeks). Major morbidity was greater in the bevacizumab group (34 vs. 19 %, p = 0.020). Nine patients died postoperatively, 5 (6.2 %) in the bevacizumab group (n = 80) and 4 (3.9 %) in the group treated with chemotherapy alone (n = 102) (p = 0.130). The rate of digestive fistulas was greater in the bevacizumab group, although not statistically significant (18 vs. 10 %, p = 0.300). The effect of bevacizumab on major morbidity (including death) was found to be statistically significant (odds ratio 2.28, 95 % confidence interval 1.05–4.95) (p = 0.04).


Administration of bevacizumab before surgery with complete cytoreduction followed by HIPEC for colorectal carcinomatosis is associated with twofold increased morbidity. The oncologic benefit of bevacizumab before HIPEC remains to be evaluated.


Bevacizumab Propensity Score Oxaliplatin Peritoneal Carcinomatosis Intraperitoneal Chemotherapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

The authors declare no conflict of interest.


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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Clarisse Eveno
    • 1
    • 2
  • Guillaume Passot
    • 3
    • 4
  • Diane Goéré
    • 5
  • Philippe Soyer
    • 6
  • Etienne Gayat
    • 7
    • 8
  • Olivier Glehen
    • 3
    • 4
  • Dominique Elias
    • 5
  • Marc Pocard
    • 1
    • 2
  1. 1.Department of Digestive DiseaseHôpital Lariboisière-AP-HP & Université Diderot-Paris 7ParisFrance
  2. 2.UMR INSERM 965-Paris 7 “Angiogenèse et recherche translationnelle”Hôpital Lariboisière-AP-HPParisFrance
  3. 3.Department of Digestive SurgeryCentre Hospitalier Lyon Sud, Université LyonPierre BéniteFrance
  4. 4.Department of Digestive SurgeryUniversité LyonLyonFrance
  5. 5.Department of Surgical OncologyInstitut Gustave RoussyVillejuif CedexFrance
  6. 6.Department of Abdominal & Interventional ImagingHôpital Lariboisière-AP-HP & Université Diderot-Paris 7ParisFrance
  7. 7.Department of Intensive CareHôpital Lariboisière-AP-HP & Université Diderot-Paris 7ParisFrance
  8. 8.Department of Biostatistics and Clinical EpidemiologyHôpital Saint-Louis-AP-HP & Université Diderot-Paris 7ParisFrance

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