Analysis Of Neoadjuvant Chemotherapy Combined With Bevacizumab For Colorectal Liver Metastasis With High Recurrence Risk Factors

Objective Colorectal liver metastasis(CRLM)has a high incidence of local recurrence and distant metastasis after radical resection.Neoadjuvant chemotherapy(NAC)can prolong the progression-free survival(PFS)for CRLM patients.The prognosis of bevacizumab(Bev)in CRLM is unclear.At present,none of the existing literature has selected CRLM patients with a Clinical Risk Score(CRS)of 3 to 5 for research.To investigate whether neoadjuvant chemotherapy combined with bevacizumab in the treatment of resectable colorectal liver metastasis with high recurrence risk factors compared with NAC alone has prognostic advantages and provides theoretical data support for clinical practice.Methods A retrospective analysis was performed on resectable CRLM patients with high recurrence risk factors treated in Zhejiang Cancer Hospital from January 2010 to December 2020.According to whether combined with Bev or not,they were automatically divided into NAC alone and combined Bev groups.We selected patients according to screening criteria and collected clinical data.The 1-year PFS and overall survival(OS)of CRLM patients were evaluated by the Kaplan-Meier survival analysis.Multivariate Cox proportional hazards regression analysis was used to study the independent factors affecting PFS and OS.Results A total of 30 CRLM patients(19 in the NAC alone group and 11 in the combined Bev group)met the inclusion criteria.There was no significant bias in the clinical baseline comparison between the two groups.Postoperative complications were 15.8%in the NAC alone group and 18.2%in the combined Bev group.R0 surgical resection was completed in both groups,and no perioperative death occurred.The 1-year PFS and OS in the NAC alone group were 15.8%and 89.5%,respectively.The 1-year PFS and OS were 36.4%and 90.9%,respectively,in the combined bevacizumab group.The PFS and OS of the combined Bev group were better than those of the NAC alone group,with statistical significance.Multivariate analysis suggested that better PFS was associated with Bev.Conclusion NAC combined with bevacizumab did not increase the probability of postoperative complications,and compared with NAC alone,it had a prognostic advantage in resectable CRLM with high recurrence risk factors.Based on the results of this study,NAC in combination with bevacizumab for resectable CRLM with high recurrence risk factors is recommended.