Effect of bevacizumab added preoperatively to oxaliplatin on liver injury and complications after resection of colorectal liver metastases

Background Chemotherapy (CTx) before resection of colorectal liver metastases (CRLM) may cause hepatic injury and postoperative complications. To ascertain whether adding bevacizumab, a monoclonal antibody against VEGF, to oxaliplatin-based CTx has an influence on liver injury and postoperative complications. Methods Patients with CRLM who received neoadjuvant CTx and underwent resection between 2003 and 2008 were analyzed whether or not they received bevacizumab added to oxaliplatin-based CTx. Results The total study group existed of 104 patients: 53 patients received oxaliplatin-based CTx and 51 patients received oxaliplatin-based CTx and bevacizumab. The overall complication rate (29%) was not significantly different between the two groups. The bevacizumab group exhibited less moderate sinusoidal dilatation (8% vs. 28%, P = 0.01). No difference in complication rate was found between patients given fewer than six cycles of oxaliplatin-based CTx and those given six or more cycles, or between patients with a short (<5 weeks) interval between the last dose of oxaliplatin and resection and those in which the interval was longer. Conclusion Bevacizumab added to oxaliplatin-based CTx may protect against moderate sinusoidal dilatation without significantly influencing morbidity. Neither duration of oxaliplatin-based CTx nor the time interval between cessation of oxaliplatin-based CTx and surgery were associated with postoperative complications. J. Surg. Oncol. 2012; 106:892-897. © 2012 Wiley Periodicals, Inc.