Abstract
Background: Liver metastases are the leading cause of death in patients with colorectal cancer. Despite advances in chemotherapy, surgical resection of hepatic metastases is still considered the only curative options. However, the majority of patients have inoperable disease at presentation. Perioperative chemotherapy is the most successful way for improved selection of patients for resection. The aim of the study was to demonstrate if and to what extent does bevacizumab, introduced in chemotherapy, increase response rates, and development of liver metastases. Methods: Our study included 50 patients who were divided in two groups. The experimental group included patients who were treated with bevacizumab plus chemotherapy, and the control group included patients who were treated with chemotherapy only. Results: The comparison showed that the patients who were treated with bevacizumab became candidates for resection of liver metastases in higher percentage (85%:52%). In addition, distribution of patients regarding the development of metastases resulted in statistically significant difference. Ratio between the patients with good response from the experimental and the control group was 67%:39%. Ratio of patients with stable disease was 26%:48%, and of patients with progressive disease, it was 7%:3%. The estimate of margin after resection was statistically insignificant. Conclusion: Bevacizumab in combination with chemotherapy in therapy of liver metastases from primary colorectal cancer improves and increases response rates and development of liver metastases.
Highlights
Colorectal carcinoma is one of three most frequent malignant diseases in both sexes [1]
Phases II and III of clinical trials have shown that the addition of bevacizumab to a standard chemotherapy significantly improves response rates (RR), the progression free survival (PFS), and the overall survival (OS) in comparison to the standard chemotherapy treatment [15, 16]
In the BEAT study, which included 1,914 patients, who received chemotherapy combined with bevacizumab added, the results showed that, R0 resection of liver metastases was performed in 76.9% out of total number of operated patients [22]
Summary
Colorectal carcinoma is one of three most frequent malignant diseases in both sexes [1]. In more than 50% of colorectal carcinoma patients’ metastases occur in liver parenchyma, 25% synchronic, i.e. detected either at the same time when the primary diseases itself or diagnosed intraoperatively. If patients with liver metastases of colorectal carcinoma stay untreated, they have a very low survival rate. In spite of progress in chemotherapy, surgical resection of liver metastases is still considered the only option for healing, with five-year long survival in 28% to 39% [5] of cases. Only 20% of total number of patients with metastatic disease in liver parenchyma is primary resectable. The results of numerous studies conducted in large world centers, confirm that neoadjuvant chemotherapy improves response rates and the transfer of unresectable patients into potential candidates for surgical resection and for their healing
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
