Lack of evidence for increased operative morbidity after hepatectomy with perioperative use of bevacizumab: A matched case-control study Journal Article
| Authors: | D'Angelica, M.; Kornprat, P.; Gonen, M.; Chung, K. Y.; Jarnagin, W. R.; DeMatteo, R. P.; Fong, Y.; Kemeny, N.; Blumgart, L. H.; Saltz, L. B. |
| Article Title: | Lack of evidence for increased operative morbidity after hepatectomy with perioperative use of bevacizumab: A matched case-control study |
| Abstract: | Background: Bevacizumab (bev) is a humanized monoclonal antibody that targets vascular endothelial growth factor (VEGF). Perioperative bev is now commonly used in patients undergoing hepatic resection. Little is known, however, about the safety of perioperative bev use in the setting of hepatic resection. Methods: Computerized pharmacy records were used to identify all patients who received bev between January 2004 and June 2005. Patients who underwent hepatectomy for colorectal metastases and received bev within 12 weeks of surgery were identified and compared with a group of matched historical controls. Results: Thirty-two patients underwent hepatic resection of colorectal cancer metastases and received bev within the specified perioperative period. Sixteen patients received bev before surgery and 24 received bev after surgery. A subset of eight patients received bev both before and after surgery. The median time between bev administration and surgery was 6.9 weeks before (range, 3-15 weeks) and 7.4 weeks after (range, 5-15 weeks). Perioperative complications occurred in 13 patients (40.6%), two of which were considered major complications. There was no statistically significant difference in perioperative morbidity and severity of complications when compared with a set of matched controls. Conclusions: Clinical experience thus far does not indicate a statistically significantly increased risk of perioperative complications with the incorporation of bev into pre- and/or postoperative treatment paradigms. Given the long half-life of bev and the potential for anti-VEGF therapy to impede wound healing and/or liver regeneration, we continue to favor a window of 6 to 8 weeks between bev administration and surgery. © 2006 Society of Surgical Oncology. |
| Keywords: | adult; clinical article; controlled study; aged; middle aged; antibiotic agent; cancer surgery; case control study; case-control studies; bevacizumab; fluorouracil; cancer combination chemotherapy; drug safety; treatment duration; liver neoplasms; comparative study; postoperative care; preoperative care; follow up; evidence based medicine; colorectal cancer; multiple cycle treatment; bleeding; antineoplastic combined chemotherapy protocols; morbidity; anticoagulant therapy; deep vein thrombosis; information processing; irinotecan; lung embolism; postoperative complication; colorectal neoplasms; postoperative complications; liver metastasis; antibodies, monoclonal; statistical significance; control group; folinic acid; urinary tract infection; liver resection; hepatectomy; perioperative period; oxaliplatin; wound infection; angiogenesis inhibitors; heart ventricle arrhythmia; perioperative care; superficial thrombophlebitis; abscess; subphrenic abscess; colorectal metastases; bev; perioperative morbidity; pharmacy |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 14 |
| Issue: | 2 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2007-02-01 |
| Start Page: | 759 |
| End Page: | 765 |
| Language: | English |
| DOI: | 10.1245/s10434-006-9074-0 |
| PUBMED: | 17103075 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 84" - "Export Date: 17 November 2011" - "CODEN: ASONF" - "Source: Scopus" |
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