title: Does stent placement for advanced colon cancer increase the risk of perforation during bevacizumab-based therapy?
abstract: 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.
authors.affiliation: Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cennamo
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fuccio
authors.forename: Vita
authors.initials: V
authors.lastname: Mutri
authors.forename: Maria Eugenia
authors.initials: ME
authors.lastname: Minardi
authors.forename: Leonardo Henry
authors.initials: LH
authors.lastname: Eusebi
authors.forename: Liza
authors.initials: L
authors.lastname: Ceroni
authors.forename: Liboria
authors.initials: L
authors.lastname: Laterza
authors.forename: Luca
authors.initials: L
authors.lastname: Ansaloni
authors.forename: Antonio Daniele
authors.initials: AD
authors.lastname: Pinna
authors.forename: Nunzio
authors.initials: N
authors.lastname: Salfi
authors.forename: Andrea Angelo
authors.initials: AA
authors.lastname: Martoni
authors.forename: Franco
authors.initials: F
authors.lastname: Bazzoli
mesh_terms: 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*
chemical_list: 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