Meta-Analysis
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World J Gastroenterol. Feb 7, 2013; 19(5): 761-768
Published online Feb 7, 2013. doi: 10.3748/wjg.v19.i5.761
Preoperative administration of bevacizumab is safe for patients with colorectal liver metastases
De-Bang Li, Feng Ye, Xiu-Rong Wu, Lu-Peng Wu, Jing-Xi Chen, Bin Li, Yan-Ming Zhou
De-Bang Li, First Department of General Surgery, First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Feng Ye, Xiu-Rong Wu, Lu-Peng Wu, Jing-Xi Chen, Bin Li, Yan-Ming Zhou, Department of Hepatobiliary and Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen 361003, Fujian Province, China
Author contributions: Li DB, Ye F, and Wu XR participated in the design and coordination of the study, carried out the critical appraisal of studies and wrote the manuscript; Wu LP, Chen JX, and Li B developed the literature search, carried out the extraction of data, assisted in the critical appraisal of included studies and assisted in writing the manuscript; Zhou YM interpreted data, corrected and approve the manuscript; all authors read and approved the final manuscript.
Correspondence to: Yan-Ming Zhou, MD, Department of Hepatobiliary and Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, 55 Zhenhai Road, Xiamen 361003, Fujian Province, China. zhouyms@yahoo.com.cn
Telephone: +86-592-2139708 Fax: +86-592-2137289
Received: August 5, 2012
Revised: November 20, 2012
Accepted: December 25, 2012
Published online: February 7, 2013
Processing time: 184 Days and 18.5 Hours
Abstract

AIM: To assess the impact of preoperative neoadjuvant bevacizumab (Bev) on the outcome of patients undergoing resection for colorectal liver metastases (CLM).

METHODS: Eligible trials were identified from Medline, Embase, Ovid, and the Cochrane database. The data were analyzed with fixed-effects or random-effects models using Review Manager version 5.0.

RESULTS: Thirteen nonrandomized studies with a total of 1431 participants were suitable for meta-analysis. There was no difference in overall morbidity and severe complications between the Bev + group and Bev - group (43.3% vs 36.8%, P = 0.06; 17.1% vs 11.4%, P = 0.07, respectively). Bev-related complications including wound and thromboembolic/bleeding events were also similar in the Bev + and Bev - groups (14.4% vs 8.1%, P = 0.21; 4.1% vs 3.8%, P = 0.98, respectively). The incidence and severity of sinusoidal dilation were lower in patients treated with Bev than in patients treated without Bev (43.3% vs 63.7%, P < 0.001; 16.8% vs 46.5%, P < 0.00, respectively).

CONCLUSION: Bev can be safely administered before hepatic resection in patients with CLM, and has a protective effect against hepatic injury in patients treated with oxaliplatin chemotherapy.

Keywords: Colorectal cancer; Liver metastases; Bevacizumab; Postoperative complication; Sinusoidal dilatation