Perioperative Chemotherapy With Bevacizumab for Colorectal Carcinomatosis

This is an interventional treatment trial for Colorectal Neoplasms focused on measuring cytoreductive surgery, hipec, perioperative chemotherapy, peritoneal carcinomatosis, bevacizumab, colorectal surgery Read More

Inclusion Criteria:

• biopsy proven adenocarcinoma of the colon or rectum and synchronous or metachronous peritoneal carcinomatosis.
• absence of systemic disease, with the exception of small, superficial liver metastases, requiring only minor surgery.
• resectable disease at staging, during laparoscopic evaluation and during exploration for cytoreductive surgery and intraperitoneal chemotherapy.
• complete macroscopic cytoreduction at the time of surgery (CC-0/1)
• good general health status (Karnofsky index > 70%)
• expected life expectancy more than 6 months
• no other malignancy than disease under study
• serum creatinine < 1.5 mg/dl or a calculated GFR ≥ 60 mL/min/1.73 m
• serum total bilirubin < 1.5 mg/dl
• platelet count > 100,000/ml
• hemoglobin > 9g/dl
• neutrophil granulocytes > 1,500/ml
• International Normalized Ration (INR) 2 or < 2
• Absence of alcohol and/or drug abuse
• No inclusion in other clinical trials interfering with the study protocol
• No concurrent chronic systemic immune therapy, chemotherapy, or hormone therapy not indicated in the study protocol
• Absence of heart failure (NYHA 2 or > 2) or significant coronary artery disease
• No pregnancy or breast feeding
• Adequate contraception in fertile patients

Exclusion Criteria:

• No written informed consent
• tumour in the presence of obstruction
• evidence of extra-abdominal disease or extensive liver metastasis
• peritoneal cancer index > 25
• active bacterial, viral or fungal infection
• active gastro-duodenal ulcer
• parenchymal liver disease (any stage cirrhosis)
• uncontrolled diabetes mellitus
• severe obstructive or restrictive respiratory insufficiency
• psychiatric pathology capable of affecting comprehension and judgment faculty
• Known allergy to oxaliplatin