[The safety of perioperative bevacizumab use].

AIM

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.

CONCLUSION

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.