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

BACKGROUND: Little 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. ME...

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Autores principales: Volk, Andreas M., Fritzmann, Johannes, Reissfelder, Christoph, Weber, Georg F., Weitz, Jürgen, Rahbari, Nuh N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750178/
https://www.ncbi.nlm.nih.gov/pubmed/26864935
http://dx.doi.org/10.1186/s12885-016-2095-6
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author Volk, Andreas M.
Fritzmann, Johannes
Reissfelder, Christoph
Weber, Georg F.
Weitz, Jürgen
Rahbari, Nuh N.
author_facet Volk, Andreas M.
Fritzmann, Johannes
Reissfelder, Christoph
Weber, Georg F.
Weitz, Jürgen
Rahbari, Nuh N.
author_sort Volk, Andreas M.
collection PubMed
description BACKGROUND: Little 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. METHODS: The 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. RESULTS: A 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; I(2) = 0 %) and hepatic fibrosis (0.61 [0.4, 0.86]; p = 0.004; I(2) = 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 I(2) = 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 I(2) = 4 %). CONCLUSIONS: The 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12885-016-2095-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-47501782016-02-12 Impact of Bevacizumab on parenchymal damage and functional recovery of the liver in patients with colorectal liver metastases Volk, Andreas M. Fritzmann, Johannes Reissfelder, Christoph Weber, Georg F. Weitz, Jürgen Rahbari, Nuh N. BMC Cancer Research Article BACKGROUND: Little 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. METHODS: The 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. RESULTS: A 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; I(2) = 0 %) and hepatic fibrosis (0.61 [0.4, 0.86]; p = 0.004; I(2) = 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 I(2) = 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 I(2) = 4 %). CONCLUSIONS: The 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12885-016-2095-6) contains supplementary material, which is available to authorized users. BioMed Central 2016-02-10 /pmc/articles/PMC4750178/ /pubmed/26864935 http://dx.doi.org/10.1186/s12885-016-2095-6 Text en © Volk et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Volk, Andreas M.
Fritzmann, Johannes
Reissfelder, Christoph
Weber, Georg F.
Weitz, Jürgen
Rahbari, Nuh N.
Impact of Bevacizumab on parenchymal damage and functional recovery of the liver in patients with colorectal liver metastases
title Impact of Bevacizumab on parenchymal damage and functional recovery of the liver in patients with colorectal liver metastases
title_full Impact of Bevacizumab on parenchymal damage and functional recovery of the liver in patients with colorectal liver metastases
title_fullStr Impact of Bevacizumab on parenchymal damage and functional recovery of the liver in patients with colorectal liver metastases
title_full_unstemmed Impact of Bevacizumab on parenchymal damage and functional recovery of the liver in patients with colorectal liver metastases
title_short Impact of Bevacizumab on parenchymal damage and functional recovery of the liver in patients with colorectal liver metastases
title_sort impact of bevacizumab on parenchymal damage and functional recovery of the liver in patients with colorectal liver metastases
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750178/
https://www.ncbi.nlm.nih.gov/pubmed/26864935
http://dx.doi.org/10.1186/s12885-016-2095-6
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