Abstract
Background
Combining conventional systemic chemotherapy with the angiogenesis inhibitor bevacizumab is now recommended as a first treatment for metastatic colorectal neoplasms. The risk for short-term postoperative complications related to bevacizumab has been assessed. Late postoperative complications related to bevacizumab have also been suggested by preliminary reports.
Methods
We reviewed a cohort of 142 patients with previous surgery for primary colonic or rectal tumor and without evidence of local recurrence, receiving bevacizumab for metastatic disease.
Results
Four patients experienced a late surgical site complication related to bevacizumab. Common features were rectal location, low anastomosis, and preoperative irradiation. Combining these three factors, the risk of a bevacizumab-related complication was 4 in 27 (14.8%); if previous history of postoperative leakage was reported, the risk was raised to 2 in 4. No complications occurred in colonic location or the non-irradiated patients. The mechanism of these complications could be ischemic lesion in post-irradiated tissues involving anastomoses.
Conclusion
We conclude that angiogenesis inhibitors should be carefully considered for patients having low colorectal anastomosis and previous irradiation.
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Acknowledgments
The authors would like to thank Dr E. Fougereau, Pharmacist in Paoli Calmettes Institute, for her contribution in collecting data; and the American Journal Experts, science & medical research paper editing and English proofreading, for revising the manuscript.
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Bège, T., Lelong, B., Viret, F. et al. Bevacizumab-Related Surgical Site Complication Despite Primary Tumor Resection in Colorectal Cancer Patients. Ann Surg Oncol 16, 856–860 (2009). https://doi.org/10.1245/s10434-008-0279-2
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DOI: https://doi.org/10.1245/s10434-008-0279-2