Abstract
Introduction
Treatment guidelines for colorectal cancer (CRC) indicate that surgical intervention
within 4 weeks or 8 weeks after bevacizumab therapy might increase the risk of postoperative
complications and mortality, especially in patients who received emergent operation.
Therefore, we aimed to assess the association between different surgical timings,
emergent or elective surgery, and the risk of postoperative mortality.
Materials and methods
Using the Taiwan National Health Insurance Database and Taiwan Cancer Registry, we
identified patients with metastatic colorectal cancer (mCRC) who underwent surgery
within 1 year of receiving bevacizumab between January 2010 and December 2017. The
primary outcomes were 30-day, 60-day, and in-hospital mortality; the secondary outcomes
were hospital stay, 30-day readmission rate, and surgical complications. Multivariate
analysis was used to adjust for confounders.
Results
This study included 2,047 patients. In the multivariate analysis, patients who underwent
emergent operation and had higher Charlson scores had a significantly higher mortality
rate. Patients with a longer interval to surgery, more cycles of bevacizumab treatment,
and distal metastectomy had the opposite result. In subgroup analysis, patients who
received emergent operation within 28 days had the highest surgical mortality.
Conclusions
The interval to operation among mCRC patients who receive bevacizumab treatment should
exceed 4 weeks to avoid additional risk of mortality whether patients receiving elective
or emergent operation. Patients who received emergent operation within 28 days of
bevcizumab infusion had the highest risk of mortality.
Keywords
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Article Info
Publication History
Published online: October 01, 2022
Accepted:
September 28,
2022
Received in revised form:
August 5,
2022
Received:
April 19,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
