Impact of Bevacizumab on parenchymal damage and functional recovery of the liver in patients with colorectal liver metastases

BMC Cancer

Research Article

Andreas M. Volk¹  Christoph Reissfelder¹  Georg F. Weber¹  Nuh N. Rahbari¹  Jürgen Weitz¹  Johannes Fritzmann¹ 

[1] Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstr. 74, D-01307, Dresden, Germany;

关键词: Bevacizumab;    Chemotherapy;    Liver resection;    Parenchymal damage;    Complications;   

DOI  :  10.1186/s12885-016-2095-6

 received in 2015-06-21, accepted in 2016-01-28,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundLittle is known about the safety of the anti-VEGF antibody bevacizumab in patients undergoing resection for colorectal liver metastases (CLM). This meta-analysis evaluates the impact of bevacizumab on parenchymal damage and functional recovery in patients undergoing resection for CLM.MethodsThe Medline, Embase and Cochrane Library were systematically searched for studies on preoperative chemotherapy with and without bevacizumab prior to resection of CLM. Studies that reported histological and/or clinical outcomes were eligible for inclusion. Meta-analyses were performed using a random effects model.ResultsA total of 18 studies with a total sample size of 2430 patients (1050 patients with bevacizumab) were found. Meta-analyses showed a significant reduction in sinusoidal obstruction syndrome (SOS) (Odds ratio 0.50 [95 % confidence interval 0.37, 0.67]; p < 0.001; I2 = 0 %) and hepatic fibrosis (0.61 [0.4, 0.86]; p = 0.004; I2 = 7 %) after preoperative chemotherapy with bevacizumab. The reduced incidence of posthepatectomy liver failure in patients with bevacizumab treatment just failed to reach statistical significance (0.61 [0.34, 1.07]; p = 0.08 I2 = 6 %). While there was no difference in perioperative morbidity and mortality, the incidence of wound complications was significantly increased in patients who received bevacizumab (1.81 [1.12, 2.91]; p = 0.02 I2 = 4 %).ConclusionsThe combination of bevacizumab with cytotoxic chemotherapy is safe but increases the incidence of wound complications after resection of CLM. The reduction of SOS and hepatic fibrosis warrant further investigation and may explain the inverse association of bevacizumab administration and posthepatectomy liver failure.

【 授权许可】

CC BY   
© Volk et al. 2016