title: Successful endoscopic stent placement as a bridge to surgery for colonic obstruction induced by bevacizumab-based chemotherapy.
abstract: The use of a self-expandable metallic stent (SEMS) as a bridge to surgery (BTS) for obstructive colorectal cancer is known to be effective. However, whether the use of a SEMS as a BTS for obstruction induced by effective chemotherapy (CTx) is useful is unknown. We present the case of a 54-year-old female patient with colorectal cancer who underwent SEMS placement as a BTS for colorectal obstruction induced by bevacizumab-based CTx. The patient was diagnosed as having transverse colon cancer with multiple liver metastases invading the inferior vena cava. Bevacizumab-based CTx was started; however, although it was effective, colonic obstruction occurred at the primary site after 31 months. A SEMS was placed as a BTS, and surgical resection of the primary lesion was performed after cessation of bevacizumab. However, the liver metastases remained unresectable. CTx was restarted after surgery, and 48-month survival was achieved. This case shows that SEMS placement as a BTS for colorectal obstruction induced by a good response to bevacizumab-based CTx was safe and beneficial. With the development of CTx and molecular-targeted agents, the frequency of colorectal obstruction associated with effective CTx is expected to increase. SEMS placement as a BTS might be one of the treatment options.
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Aichi Hospital, 18 Kuriyado, Kakemachi, Okazaki, Aichi, 444-0011, Japan. sy-kondo@acc-aichi.com.
authors.forename: Shinya
authors.initials: S
authors.lastname: Kondo
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Aichi Hospital, 18 Kuriyado, Kakemachi, Okazaki, Aichi, 444-0011, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Fujita
authors.affiliation: Laboratory of Pathology and Clinical Research, Aichi Cancer Center Aichi Hospital, Okazaki, Japan.
authors.forename: Hayao
authors.initials: H
authors.lastname: Nakanishi
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Aichi Hospital, 18 Kuriyado, Kakemachi, Okazaki, Aichi, 444-0011, Japan.
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Tsuzuki
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Aichi Hospital, 18 Kuriyado, Kakemachi, Okazaki, Aichi, 444-0011, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sobajima
authors.affiliation: Department of Gastrointestinal Surgery, Aichi Cancer Center Aichi Hospital, Okazaki, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kojima
authors.affiliation: Department of Gastrointestinal Surgery, Aichi Cancer Center Aichi Hospital, Okazaki, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Okada
authors.affiliation: Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Goto
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Aichi Hospital, 18 Kuriyado, Kakemachi, Okazaki, Aichi, 444-0011, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Sakakibara
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000068258:Bevacizumab / Q000009:adverse effects*; D003110:Colonic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000068258:Bevacizumab
keywords: Bevacizumab; Bridge to surgery; Obstructive colorectal cancer; Self-expandable metallic stent