Does Stent Placement for Advanced Colon Cancer Increase the Risk of Perforation During Bevacizumab-Based Therapy?

Background & Aims: 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. © 2009 AGA Institute.