Ondrej Troup1, Adam Skalicky1, Lucie Vistejnova2,3, Pavel Klein2, Anna Maleckova4, Blanka Florova2, Tomas Malkus5, Jiri Molacek6, Vladislav Treska6, Miroslav Kriz7, Jan Zeman8, Tomas Skalicky9. 1. Department of Plastic Surgery, Medical School and Teaching Hospital in Pilsen, Charles University, Pilsen, Czech Republic. 2. Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic. 3. Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic. 4. European Centre of Excellence NTIS, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic. 5. Department of Radiology, Medical School and Teaching Hospital in Pilsen, Charles University, Pilsen, Czech Republic. 6. Department of Surgery, Medical School and Teaching Hospital in Pilsen, Charles University, Pilsen, Czech Republic. 7. First Department of Internal Medicine, Medical School and Teaching Hospital in Pilsen, Charles University, Pilsen, Czech Republic. 8. Department of Orthopedics and Traumatology, Medical School and Teaching Hospital in Pilsen, Charles University, Pilsen, Czech Republic. 9. Department of Surgery, Medical School and Teaching Hospital in Pilsen, Charles University, Pilsen, Czech Republic; skalickya@fnplzen.cz.
Abstract
BACKGROUND/AIM: Patients with unresectable liver colorectal cancer metastases are treated with neoadjuvant chemotherapy often accompanied by biological therapy aimed at reducing the mass of metastases and thus increasing the chances of resectability. Bevacizumab comprises an anti-VEGF (vascular endothelial growth factor) humanized IgG monoclonal antibody that is used for biological therapy purposes. It acts to inhibit angiogenesis, thereby slowing down the growth of metastases. Due to its being administered systematically, bevacizumab also exerts an effect on the surrounding healthy liver parenchyma and potentially limits the process of neovascularization and thus regeneration of the liver. Since the remnant liver volume forms an important factor in postoperative morbidity and mortality following a major hepatectomy, we decided to study the effect of bevacizumab on vascular and biliary microarchitecture in healthy liver parenchyma and its ability to regenerate following major hepatectomy. MATERIALS AND METHODS: We performed an experiment employing a large animal model where a total of 16 piglets were divided into two groups (8 piglets in the control group and 8 piglets in the experimental group with bevacizumab). All the animals were subjected to major hepatectomy and the experimental group was given bevacizumab prior to hepatectomy. All the animals were sacrificed after 4 weeks. We performed biochemical analyses at regular time intervals during the follow-up period. Histological examination of the liver tissue was performed following sacrifice of the animals. RESULTS: No statistical difference was shown between groups in terms of the biochemical and immunohistochemical parameters. The histological examination of the regenerating liver tissue revealed the higher length density of sinusoids in the experimental group. CONCLUSION: Bevacizumab does not act to impair liver regeneration following hepatectomy.
BACKGROUND/AIM: Patients with unresectable liver colorectal cancer metastases are treated with neoadjuvant chemotherapy often accompanied by biological therapy aimed at reducing the mass of metastases and thus increasing the chances of resectability. Bevacizumab comprises an anti-VEGF (vascular endothelial growth factor) humanized IgG monoclonal antibody that is used for biological therapy purposes. It acts to inhibit angiogenesis, thereby slowing down the growth of metastases. Due to its being administered systematically, bevacizumab also exerts an effect on the surrounding healthy liver parenchyma and potentially limits the process of neovascularization and thus regeneration of the liver. Since the remnant liver volume forms an important factor in postoperative morbidity and mortality following a major hepatectomy, we decided to study the effect of bevacizumab on vascular and biliary microarchitecture in healthy liver parenchyma and its ability to regenerate following major hepatectomy. MATERIALS AND METHODS: We performed an experiment employing a large animal model where a total of 16 piglets were divided into two groups (8 piglets in the control group and 8 piglets in the experimental group with bevacizumab). All the animals were subjected to major hepatectomy and the experimental group was given bevacizumab prior to hepatectomy. All the animals were sacrificed after 4 weeks. We performed biochemical analyses at regular time intervals during the follow-up period. Histological examination of the liver tissue was performed following sacrifice of the animals. RESULTS: No statistical difference was shown between groups in terms of the biochemical and immunohistochemical parameters. The histological examination of the regenerating liver tissue revealed the higher length density of sinusoids in the experimental group. CONCLUSION: Bevacizumab does not act to impair liver regeneration following hepatectomy.
Authors: Aurelien Dupre; Andrea Paradisi; Stephan Langonnet; Alessandro Gandini; Patrick Mehlen; Michel Rivoire Journal: Anticancer Res Date: 2012-12 Impact factor: 2.480
Authors: Jack Martin; Angelica Petrillo; Elizabeth C Smyth; Nadeem Shaida; Samir Khwaja; H K Cheow; Adam Duckworth; Paula Heister; Raaj Praseedom; Asif Jah; Anita Balakrishnan; Simon Harper; Siong Liau; Vasilis Kosmoliaptsis; Emmanuel Huguet Journal: World J Clin Oncol Date: 2020-10-24