title: Preoperative Chemotherapy with Bevacizumab Extends Disease-free Survival After Resection of Liver Metastases from Colorectal Cancer.
abstract: BACKGROUND
  The benefit of preoperative chemotherapy for patients with liver metastases from colorectal cancer remains unclear. We evaluated the efficacy of preoperative chemotherapy with bevacizumab in such patients, and attempted to identify clinical predictors of recurrence.
  
  
  METHODS
  Between February 2007 and December 2013, a total of 65 liver resections for colorectal metastases were performed at our Institution; 47 patients underwent preoperative chemotherapy, which consisted of modified FOLFOX6 (mFOLFOX6) in 42 cases. The last clinical follow-up was in December 2014. Demographic and clinicopathological factors were reviewed for each patient, and potential predictors of recurrence after liver resection were evaluated. Disease-free survival (DFS) and overall survival (OS) were compared with respect to clinicopathological factors.
  
  
  RESULTS
  The 3- and 5-year OS rates were 73.9% and 62.5%, respectively. The time at which metastases appeared, and the extent of metastasis according to the Japanese classification did not significantly affect OS or DFS. However, mFOLFOX6 plus bevacizumab significantly improved DFS compared to mFOLFOX6 alone. Patients did not experience worsening of hepatic dysfunction during preoperative chemotherapy, and tolerated surgical stress well.
  
  
  CONCLUSIONS
  Preoperative chemotherapy with bevacizumab appears to be an effective treatment modality for liver metastases from colorectal cancer, and results in prolonged DFS.
authors.affiliation: Department of Surgery, Aomori Prefectural Central Hospital, Aomori, Japan mumehara@med.pref.aomori.jp.
authors.forename: Minoru
authors.initials: M
authors.lastname: Umehara
authors.affiliation: Department of Surgery, Aomori Prefectural Central Hospital, Aomori, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Umehara
authors.affiliation: Department of Surgery, Aomori Prefectural Central Hospital, Aomori, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Surgery, Aomori Prefectural Central Hospital, Aomori, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Murata
authors.affiliation: Department of Surgery, Aomori Prefectural Central Hospital, Aomori, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nishikawa
authors.affiliation: Department of Surgery, Aomori Prefectural Central Hospital, Aomori, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Tokura
authors.affiliation: Department of Cancer Epidemiology and Community Health, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Matsuzaka
authors.affiliation: Department of Cancer Epidemiology and Community Health, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Rina
authors.initials: R
authors.lastname: Tanaka
authors.affiliation: Department of Surgery, Aomori Prefectural Central Hospital, Aomori, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Morita
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006498:Hepatectomy; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D057234:Preoperative Period; D016019:Survival Analysis
chemical_list: D020533:Angiogenesis Inhibitors; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil
keywords: FOLFOX; bevacizumab; colorectal cancer; liver metastasis