[The safety of perioperative bevacizumab use].
OBJECTIVE
Patients with colorectal cancer and liver metastases can benefit from preoperative chemotherapy and liver disease resection. Adjunction of bevacizumab (BV) to chemotherapy improves survival in these patients, but its impact on surgical complications remains to be fully determined.


METHODS
We reviewed all studies addressing mortality and morbidity following hepatectomy in patients preoperatively treated with a combination of BV and chemotherapy.


RESULTS
All available data are retrospective. For all patients, the interval between BV and surgery was at least one month. As compared to chemotherapy alone, they demonstrate no significant increase of the incidence of surgical complications, including wound healing delays, hepatocellular insufficiency, infections, and bleeding.


CONCLUSIONS
We still recommend managing an interval of at least 6 weeks from discontinuation of bevacizumab to hepatic resection, and at least 4 weeks from surgery to retreatment with bevacizumab. This recommendation is based on retrospective data and small numbers of patients, all indicating that BV use has no deleterious impact on postoperative morbidity and mortality.
Mariani
P
P
Unité de chirurgie digestive, Institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, France. pascale.mariani@curie.net
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000068258:Bevacizumab; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000473:pathology; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D020360:Neoadjuvant Therapy; D012004:Rectal Neoplasms / Q000473:pathology; D012189:Retrospective Studies; D012449:Safety; D013997:Time Factors; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab