Bevacizumab‐associated intestinal perforation and perioperative complications in patients receiving bevacizumab
Abstract Aim The purposes of this study are to present cases of emergency surgery in which gastrointestinal perforation occurred during bevacizumab administration, consider the indications for emergency surgery, and examine the safety of scheduled surgery after a washout period for bevacizumab. Meth...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-03-01
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| Series: | Annals of Gastroenterological Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ags3.12312 |
| _version_ | 1823961907760988160 |
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| author | Toshiaki Yoshimoto Kozo Yoshikawa Jun Higashijima Tomohiko Miyatani Takuya Tokunaga Masaaki Nishi Chie Takasu Hideya Kashihara Yukako Takehara Mitsuo Shimada |
| author_facet | Toshiaki Yoshimoto Kozo Yoshikawa Jun Higashijima Tomohiko Miyatani Takuya Tokunaga Masaaki Nishi Chie Takasu Hideya Kashihara Yukako Takehara Mitsuo Shimada |
| author_sort | Toshiaki Yoshimoto |
| collection | DOAJ |
| description | Abstract Aim The purposes of this study are to present cases of emergency surgery in which gastrointestinal perforation occurred during bevacizumab administration, consider the indications for emergency surgery, and examine the safety of scheduled surgery after a washout period for bevacizumab. Methods (a) We retrospectively investigated seven patients who underwent emergency surgery for bevacizumab‐associated intestinal perforation. (b) We investigated 104 patients with advanced colorectal cancer treated with neoadjuvant therapy who underwent surgery from 2008 to 2018, retrospectively. Results (a) In the seven patients undergoing emergency surgery for gastrointestinal perforation, the median bevacizumab administration and washout periods were 16 weeks and 24 days, respectively. A stoma was created in all patients except in those who were not candidates. Two patients developed postoperative abdominal abscesses, and two patients died from perioperative sepsis and gastrointestinal bleeding, respectively; both of these patients had poor performance status. (b) In patients receiving bevacizumab (n = 45) and patients treated with bevacizumab‐free regimens as neoadjuvant therapy (n = 59), 31 and 52 patients received chemoradiotherapy, respectively. We found no correlation with postoperative complications with or without bevacizumab. Conclusion The surgical indications should be considered carefully in patients with gastrointestinal perforation secondary to bevacizumab administration. Meanwhile, after appropriate cessation time, scheduled surgery following bevacizumab administration is feasible. |
| first_indexed | 2024-12-17T17:10:59Z |
| format | Article |
| id | doaj.art-8f5501f8324b4961b6ed2def644de5a4 |
| institution | Directory Open Access Journal |
| issn | 2475-0328 |
| language | English |
| last_indexed | 2024-12-17T17:10:59Z |
| publishDate | 2020-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj.art-8f5501f8324b4961b6ed2def644de5a42022-12-21T21:40:04ZengWileyAnnals of Gastroenterological Surgery2475-03282020-03-014215115510.1002/ags3.12312Bevacizumab‐associated intestinal perforation and perioperative complications in patients receiving bevacizumabToshiaki Yoshimoto0Kozo Yoshikawa1Jun Higashijima2Tomohiko Miyatani3Takuya Tokunaga4Masaaki Nishi5Chie Takasu6Hideya Kashihara7Yukako Takehara8Mitsuo Shimada9Department of Surgery Tokushima University Tokushima JapanDepartment of Surgery Tokushima University Tokushima JapanDepartment of Surgery Tokushima University Tokushima JapanDepartment of Surgery Tokushima University Tokushima JapanDepartment of Surgery Tokushima University Tokushima JapanDepartment of Surgery Tokushima University Tokushima JapanDepartment of Surgery Tokushima University Tokushima JapanDepartment of Surgery Tokushima University Tokushima JapanDepartment of Surgery Tokushima University Tokushima JapanDepartment of Surgery Tokushima University Tokushima JapanAbstract Aim The purposes of this study are to present cases of emergency surgery in which gastrointestinal perforation occurred during bevacizumab administration, consider the indications for emergency surgery, and examine the safety of scheduled surgery after a washout period for bevacizumab. Methods (a) We retrospectively investigated seven patients who underwent emergency surgery for bevacizumab‐associated intestinal perforation. (b) We investigated 104 patients with advanced colorectal cancer treated with neoadjuvant therapy who underwent surgery from 2008 to 2018, retrospectively. Results (a) In the seven patients undergoing emergency surgery for gastrointestinal perforation, the median bevacizumab administration and washout periods were 16 weeks and 24 days, respectively. A stoma was created in all patients except in those who were not candidates. Two patients developed postoperative abdominal abscesses, and two patients died from perioperative sepsis and gastrointestinal bleeding, respectively; both of these patients had poor performance status. (b) In patients receiving bevacizumab (n = 45) and patients treated with bevacizumab‐free regimens as neoadjuvant therapy (n = 59), 31 and 52 patients received chemoradiotherapy, respectively. We found no correlation with postoperative complications with or without bevacizumab. Conclusion The surgical indications should be considered carefully in patients with gastrointestinal perforation secondary to bevacizumab administration. Meanwhile, after appropriate cessation time, scheduled surgery following bevacizumab administration is feasible.https://doi.org/10.1002/ags3.12312bevacizumabcanceremergenciesperforationpostoperative complications |
| spellingShingle | Toshiaki Yoshimoto Kozo Yoshikawa Jun Higashijima Tomohiko Miyatani Takuya Tokunaga Masaaki Nishi Chie Takasu Hideya Kashihara Yukako Takehara Mitsuo Shimada Bevacizumab‐associated intestinal perforation and perioperative complications in patients receiving bevacizumab Annals of Gastroenterological Surgery bevacizumab cancer emergencies perforation postoperative complications |
| title | Bevacizumab‐associated intestinal perforation and perioperative complications in patients receiving bevacizumab |
| title_full | Bevacizumab‐associated intestinal perforation and perioperative complications in patients receiving bevacizumab |
| title_fullStr | Bevacizumab‐associated intestinal perforation and perioperative complications in patients receiving bevacizumab |
| title_full_unstemmed | Bevacizumab‐associated intestinal perforation and perioperative complications in patients receiving bevacizumab |
| title_short | Bevacizumab‐associated intestinal perforation and perioperative complications in patients receiving bevacizumab |
| title_sort | bevacizumab associated intestinal perforation and perioperative complications in patients receiving bevacizumab |
| topic | bevacizumab cancer emergencies perforation postoperative complications |
| url | https://doi.org/10.1002/ags3.12312 |
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