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Medline ® Abstract for Reference 88

of 'Toxicity of molecularly targeted antiangiogenic agents: Non-cardiovascular effects'

88
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Bevacizumab-related surgical site complication despite primary tumor resection in colorectal cancer patients.
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Bège T, Lelong B, Viret F, Turrini O, Guiramand J, Topart D, Moureau-Zabotto L, Giovannini M, Gonçalves A, Delpero JR
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Ann Surg Oncol. 2009;16(4):856. Epub 2009 Jan 21.
 
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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Department of Surgical Oncology, Paoli Calmettes Institute, Regional Comprehensive Cancer Center, Marseille, France. beget@hotmail.fr
PMID