Kim Seijong, Shin Jung Kyong, Park Yoonah, Huh Jung Wook, Kim Hee Cheol, Yun Seong Hyeon, Lee Woo Yong, Cho Yong Beom
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.
Front Oncol. 2022 Oct 21;12:1018458. doi: 10.3389/fonc.2022.1018458. eCollection 2022.
Bevacizumab is a humanized monoclonal antibody against vascular endothelial growth factor and is used in combination with first-line chemotherapy in the treatment of metastatic colorectal cancer. One of the side effects of bevacizumab is gastrointestinal perforation. This study was designed to identify the effect of bevacizumab in intestinal anastomosis site healing.
From January 2010 to December 2020, patients diagnosed with stage IV colorectal cancer treated with palliative chemotherapy or chemoradiotherapy followed by radical surgery were retrospectively reviewed. Clinical signs or symptoms and computed tomography were tools used for diagnosing anastomosis site leakage. The patients were divided into two groups, the bevacizumab group (n = 136) and the non-bevacizumab group (n = 124).
Among the 260 patients 14 (5.4%) patients were diagnosed with anastomosis site leakage. In the bevacizumab group, 13 (9.6%) patients were diagnosed with anastomotic leakage. In the non-bevacizumab group, 1 (0.8%) patient was diagnosed with anastomotic leakage. Anastomosis site leakage was significantly higher in the bevacizumab treatment group (P < 0.001). In the bevacizumab group, period of drug discontinuation before surgery was factor associated with anastomosis site leakage in multivariable analysis (P = 0.031).
Stage IV colorectal patients treated with bevacizumab before radical surgery for primary cancer should be carefully observed of anastomosis site leakage after surgery, and the period of drug discontinuation before surgery should be longer than 5 weeks to avoid anastomosis site leakage.
贝伐单抗是一种抗血管内皮生长因子的人源化单克隆抗体，用于联合一线化疗治疗转移性结直肠癌。贝伐单抗的副作用之一是胃肠道穿孔。本研究旨在确定贝伐单抗对肠吻合口愈合的影响。
回顾性分析2010年1月至2020年12月期间诊断为IV期结直肠癌并接受姑息化疗或放化疗后行根治性手术的患者。临床体征或症状以及计算机断层扫描是用于诊断吻合口漏的工具。患者分为两组，贝伐单抗组（n = 136）和非贝伐单抗组（n = 124）。
260例患者中，14例（5.4%）被诊断为吻合口漏。贝伐单抗组中，13例（9.6%）患者被诊断为吻合口漏。非贝伐单抗组中，1例（0.8%）患者被诊断为吻合口漏。贝伐单抗治疗组的吻合口漏发生率显著更高（P < 0.001）。在贝伐单抗组中，多变量分析显示术前停药时间是与吻合口漏相关的因素（P = 0.031）。
原发性癌症根治术前接受贝伐单抗治疗的IV期结直肠癌患者术后应仔细观察吻合口漏情况，术前停药时间应超过5周以避免吻合口漏。
