{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:45:58Z","timestamp":1788432358152,"version":"build-2803163510"},"reference-count":18,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T00:00:00Z","timestamp":1606953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Preoperative bevacizumab has been reported to increase postoperative complication risk following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS\/HIPEC). We sought to review our experience with preoperative bevacizumab in patients undergoing CRS\/HIPEC for peritoneal surface malignancy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This is a retrospective review of patients who received neoadjuvant systemic therapy with or without bevacizumab prior to CRS\/HIPEC at a high-volume academic center from 2007\u20132018.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 499 patients, a total of 88 patients received neoadjuvant chemotherapy alone (n = 34) or in combination with bevacizumab (n = 54) within 3 months prior to CRS\/HIPEC. No differences existed in 60-day major morbidity (17.6 vs. 16.7%, p = 0.81) or 60-day mortality (0 vs. 0%) between the two cohorts, and neoadjuvant bevacizumab was not associated with increased odds of overall complications (OR 0.86, 95% CI 0.35\u20132.09, p = 0.73) or major morbidity (OR 0.86, 95% CI 0.24\u20133.00, p = 0.81). Stratifying patients by primary tumor origin and post-operative complications did not reveal any significant differences between the two treatment groups. In addition, progression-free survival (PFS) and overall survival (OS) were similar in both cohorts.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Preoperative bevacizumab is not associated with increased morbidity or mortality following CRS\/HIPEC. Neoadjuvant therapy employing this biologic agent is safe and should not be a deterrent for aggressive cytoreduction with curative intent.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0243252","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T18:51:20Z","timestamp":1607021480000},"page":"e0243252","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Preoperative bevacizumab does not increase complications following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4989-4298","authenticated-orcid":true,"given":"Bradley H.","family":"King","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel M.","family":"Baumgartner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn J.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca A.","family":"Marmor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Lowy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jula","family":"Veerapong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,12,3]]},"reference":[{"issue":"8","key":"pone.0243252.ref001","doi-asserted-by":"crossref","first-page":"2152","DOI":"10.1245\/s10434-009-0487-4","article-title":"A systematic review and meta-analysis of cytoreductive surgery with perioperative intraperitoneal chemotherapy for peritoneal carcinomatosis of colorectal origin","volume":"16","author":"C. Cao","year":"2009","journal-title":"Annals of Surgical Oncology"},{"issue":"23","key":"pone.0243252.ref002","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.1056\/NEJMoa032691","article-title":"Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer","volume":"350","author":"H. Hurwitz","year":"2004","journal-title":"New England Journal of Medicine"},{"issue":"12","key":"pone.0243252.ref003","doi-asserted-by":"crossref","first-page":"2013","DOI":"10.1200\/JCO.2007.14.9930","article-title":"Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase III study","volume":"26","author":"L. B. 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Carmeliet","year":"2000","journal-title":"Nature"},{"issue":"21","key":"pone.0243252.ref006","doi-asserted-by":"crossref","first-page":"4368","DOI":"10.1200\/JCO.2002.10.088","article-title":"Vascular permeability factor\/vascular endothelial growth factor: a critical cytokine in tumor angiogenesis and a potential target for diagnosis and therapy","volume":"20","author":"H. F. Dvorak","year":"2002","journal-title":"Journal of Clinical Oncology"},{"issue":"6","key":"pone.0243252.ref007","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1038\/nm0603-669","article-title":"The biology of VEGF and its receptors","volume":"9","author":"N. Ferrara","year":"2003","journal-title":"Nature Medicine"},{"issue":"38","key":"pone.0243252.ref008","doi-asserted-by":"crossref","first-page":"5356","DOI":"10.1038\/sj.onc.1203035","article-title":"New model of tumor angiogenesis: dynamic balance between vessel regression and growth mediated by angiopoietins and VEGF","volume":"18","author":"J. Holash","year":"1999","journal-title":"Oncogene"},{"issue":"1\u20132","key":"pone.0243252.ref009","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s10555-011-9337-5","article-title":"Significance of vascular endothelial growth factor in growth and peritoneal dissemination of ovarian cancer","volume":"31","author":"S. M. Moghaddam","year":"2012","journal-title":"Cancer and Metastasis Reviews"},{"issue":"2","key":"pone.0243252.ref010","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1001\/jamasurg.2013.3640","article-title":"Surgical outcomes of hyperthermic intraperitoneal chemotherapy: analysis of the American College of Surgeons national surgical quality improvement program","volume":"149","author":"M. D. Jafari","year":"2014","journal-title":"JAMA Surgery"},{"issue":"12","key":"pone.0243252.ref011","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1038\/sj.bjc.6603813","article-title":"Mechanisms of adverse effects of anti-VEGF therapy for cancer","volume":"96","author":"T. Kamba","year":"2007","journal-title":"British Journal of Cancer"},{"issue":"9","key":"pone.0243252.ref012","first-page":"862","article-title":"Clinical outcomes associated with bevacizumab-containing treatment of metastatic colorectal cancer: the BRiTE observational cohort study","volume":"14","author":"M. Kozloff","year":"2009","journal-title":"The Oncology"},{"issue":"3","key":"pone.0243252.ref013","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1002\/jso.20301","article-title":"Surgical wound healing complications in metastatic colorectal cancer patients treated with bevacizumab","volume":"91","author":"F. A. Scappaticci","year":"2005","journal-title":"Journal of Surgical Oncology"},{"key":"pone.0243252.ref014","doi-asserted-by":"crossref","first-page":"S26","DOI":"10.1053\/j.seminoncol.2006.08.001","article-title":"Bevacizumab in the treatment of metastatic colorectal cancer: safety profile and management of adverse events","volume":"33","author":"H. Hurwitz","year":"2006","journal-title":"Seminars in Oncology"},{"issue":"6","key":"pone.0243252.ref015","doi-asserted-by":"crossref","first-page":"1792","DOI":"10.1245\/s10434-013-3442-3","article-title":"Bevacizumab doubles the early postoperative complication rate after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis of colorectal origin","volume":"21","author":"C. Eveno","year":"2014","journal-title":"Annals of Surgical Oncology"},{"issue":"9","key":"pone.0243252.ref016","doi-asserted-by":"crossref","first-page":"3023","DOI":"10.1245\/s10434-014-3713-7","article-title":"Neoadjuvant chemotherapy with bevacizumab may improve outcome after cytoreduction and hyperthermic intraperitoneal chemoperfusion (HIPEC) for colorectal carcinomatosis","volume":"21","author":"W. Ceelen","year":"2014","journal-title":"Annals of Surgical Oncology"},{"issue":"4","key":"pone.0243252.ref017","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1245\/s10434-012-2789-1","article-title":"Assessment of neoadjuvant chemotherapy on operative parameters and outcome in patients with peritoneal dissemination from high-grade appendiceal cancer","volume":"20","author":"K. M. 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Kudsk","year":"2003","journal-title":"Journal of Parenteral and Enteral Nutrition"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0243252","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T18:51:27Z","timestamp":1607021487000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0243252"}},"subtitle":[],"editor":[{"given":"Elizabeth","family":"Christie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,12,3]]},"references-count":18,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,3]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0243252","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,3]]}}}