Complications after colorectal anastomosis in a patient with metastatic rectal cancer treated with systemic chemotherapy and bevacizumab.
Bibliographic record
Abstract
Bevacizumab (Avastin; Genentech, San Francisco, Calif.) is the first humanized monoclonal antibody targeting vascular endothelial growth factor receptor to be approved in combination with systemic chemotherapy for the treatment of advanced colorectal cancer.1 Despite its survival advantage for patients with metastatic colorectal cancer, this drug can delay healing of the wound and anastomosis.2 Because the half-life of bevacizumab is 20 (11–50) days, which the drug monograph makes clear, bevacizumab should be stopped 28 days before a surgical procedure to minimize complications.2 Scappaticci and colleagues2 reported a 13% rate of wound complications in patients who underwent laparotomy less than 28 days after the last dose of bevacizumab, together with a rapidly decreasing risk of complications after that time. For many reasons, patients with metastatic colorectal cancer are more likely than others to require emergency surgical procedures.3 Because bevacizumab is used in a growing number of people with metastatic colorectal cancer, surgeons will have to operate increasingly frequently on this high-risk population. The purpose of this case report is to highlight the need for special precautions when a laparotomy is mandatory in patients treated with bevacizumab.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.006 | 0.006 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".