Does stent placement for advanced colon cancer increase the risk of perforation during bevacizumab-based therapy?
OBJECTIVE
Data on the safety of bevacizumab-based therapies for patients carrying a self-expandable metallic stent (SEMS) for occlusive colon cancer are lacking. We report 2 cases of colon perforation observed in our case series of patients with SEMS for occlusive colon cancer.


METHODS
Patients with occlusive symptoms caused by colon cancer received a colonic stent under endoscopic and radiologic guidance.


RESULTS
Over a 10-month period, 28 patients with occlusive colon cancer were treated with stent placement. The stent was placed as a bridge to surgery in 12 patients who were treated surgically within 4 to 78 days after the endoscopic procedures, without any stent-related complications. Seven patients did not receive any other antitumor treatment as a result of concomitant comorbidities. Nine patients with both primary tumor and metastatic lesions were treated with medical therapy. Over a median follow-up period of 131 days colonic perforation occurred in the 2 patients treated with a combination of capecitabine and oxaliplatin plus bevacizumab.


CONCLUSIONS
Further studies are needed to clarify whether SEMS placement increases the risk of perforation caused by bevacizumab-based therapies.
Cennamo
Vincenzo
V
Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy.
Fuccio
Lorenzo
L
Mutri
Vita
V
Minardi
Maria Eugenia
ME
Eusebi
Leonardo Henry
LH
Ceroni
Liza
L
Laterza
Liboria
L
Ansaloni
Luca
L
Pinna
Antonio Daniele
AD
Salfi
Nunzio
N
Martoni
Andrea Angelo
AA
Bazzoli
Franco
F
D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000068258:Bevacizumab; D000069287:Capecitabine; D003110:Colonic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005472:Fluorouracil / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin; D018570:Risk Assessment; D015607:Stents / Q000009:adverse effects*
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000068258:Bevacizumab; D000069287:Capecitabine; D005472:Fluorouracil