Their median age was 57 years (range 41�C78 years); 24 (68.6%) patients were male (Table 1). The colon was the primary site in 31 patients (88.6%). All patients were Eastern Cooperative Oncology Group (ECOG) status 2 or lower. The median selleck chem number of lesions per patient was three (range 1�C13). Twelve patients (34.3%) underwent staged resections for major bilobar disease involvement. Seventeen patients (48.6%) underwent PVE prior to resection. Table 1 Baseline characteristics In all, 26 (74.3%) patients received oxaliplatin-based cytotoxic chemotherapy. Six (17.1%) patients received irinotecan-based therapy and the remainder received both perioperatively. A median of six (range 4�C16) cycles of Bev were administered preoperatively and a median of six (range 0�C12) cycles were given postoperatively.
The median delay between the last dose of Bev and surgery was 8 weeks (range 6�C14 weeks). Chemotherapy-related toxicity Chemotherapy-related toxicities occurred in approximately two-thirds of patients (Table 2). Thirteen (37.1%) patients had no significant toxicity related to chemotherapy. Nine patients (25.7%) had toxicities of grade 3 or higher. Three (8.6%) patients experienced grade 4 toxicities, all of which were gastrointestinal in origin. Only four toxicity events were deemed to be directly related to Bev; these concerned one patient who developed an anaphylactic reaction, two patients with hypertension, and one patient with a significant episode of epistaxis. There were no arterial thromboembolic events or gastrointestinal perforations.
Table 2 Chemotherapy-related toxicity Response to chemotherapy Response rate was assessed according to RECIST criteria (Table 3). The overall response rate was 65.7% (complete response and partial response). A total of 21 patients (31.4%) achieved stable disease. Only one patient progressed while on preoperative chemotherapy, but this did not prevent an R0 resection. Table 3 Response to chemotherapy Perioperative data A total of 35 patients underwent 41 hepatectomies. Overall, 22 right hepatectomies, seven left hepatectomies, seven left lateral sectionectomies, two extended right hepatectomies and three segmental resections were performed. The median blood loss was 1100 ml (range 200�C4000 ml). Mean duration of surgery was 185 min (range 95�C350 min). The majority of patients (70.7%) did not require intraoperative transfusion.
Postoperative complications There were no perioperative mortalities in this series. The overall incidence of morbidity was 42.3% (Table 4). A total of 23 complications occurred in 15 patients. Of these, only five (21.7%) were grade 3 or higher according to the Clavien system.20 Ten patients experienced 13 infectious complications (five urinary tract infections, four wound infections, one episode of Clostridium difficile diarrhoea, Batimastat one central line infection, one pneumonia and one intra-abdominal abscess).
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