Preoperative administration of bevacizumab is safe for patients with colorectal liver metastases

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.