Perioperative Complications After Neoadjuvant Chemotherapy With and Without Bevacizumab for Colorectal Liver Metastases

Nir Lubezky, Evan Winograd, Michael Papoulas, Guy Lahat, Einat Shacham-Shmueli, Ravit Geva, Richard Nakache, Joseph Klausner, Menahem Ben-Haim

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Bevacizumab has been shown to increase progression free and overall survival in patients with metastatic colorectal cancer. Neoadjuvant bevacizumab is commonly used in patients undergoing liver resection. Our purpose was to evaluate whether bevacizumab is associated with increased rate of perioperative complications in patients undergoing hepatic resection for colorectal liver metastases (CRLM). Methods: Retrospective analysis of patients undergoing hepatic resection for CRLM who received chemotherapy and bevacizumab (group 1, n = 134), or chemotherapy alone (group 2, n = 57). We compared demographics, surgical characteristics, and perioperative course. Results: Perioperative complications developed in 35 % of patients in group 1, and 47 % in group 2 (p = 0. 11). Of those complications, 15 (11. 2 %) in group 1, and 5 (8. 8 %) in group 2 were considered major (p = 0. 617). Four patients, all of whom received preoperative bevacizumab, developed enteric leaks following combined liver and bowel resection. The rate of anastomotic leak in group 1 was 10 %, compared with 0 in group 2, p = 0. 56. Conclusion: Neoadjuvant chemotherapy along with bevacizumab was not associated with an increased risk of postoperative complications after hepatic resection. Possible association of increased morbidity with simultaneous bowel and liver resections following bevacizumab administration was found and we recommend avoiding such treatment combination.

Original languageEnglish
Pages (from-to)527-532
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume17
Issue number3
DOIs
StatePublished - Mar 2013

Keywords

  • Bevacizumab
  • Colorectal liver metastases
  • Neoadjuvant chemotherapy
  • Perioperative complications

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