Does stent placement for advanced colon cancer increase the risk of perforation during bevacizumab-based therapy?

Clin Gastroenterol Hepatol. 2009 Nov;7(11):1174-6. doi: 10.1016/j.cgh.2009.07.015. Epub 2009 Jul 22.


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.

MeSH terms

  • Angiogenesis Inhibitors / adverse effects*
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents / therapeutic use
  • Bevacizumab
  • Capecitabine
  • Colonic Neoplasms / complications*
  • Colonic Neoplasms / drug therapy
  • Colonic Neoplasms / surgery
  • Deoxycytidine / analogs & derivatives
  • Deoxycytidine / therapeutic use
  • Fluorouracil / analogs & derivatives
  • Fluorouracil / therapeutic use
  • Humans
  • Intestinal Perforation / etiology*
  • Organoplatinum Compounds / therapeutic use
  • Oxaliplatin
  • Risk Assessment*
  • Stents / adverse effects*


  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Organoplatinum Compounds
  • Oxaliplatin
  • Deoxycytidine
  • Bevacizumab
  • Capecitabine
  • Fluorouracil