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.
Improved Selection of Patients for Hepatic Surgery of Colorectal Liver Metastases with 18F-FDG PET: A Randomized Study