Document Detail

Which factors predict bowel complications in patients with recurrent epithelial ovarian cancer being treated with bevacizumab?
MedLine Citation:
PMID:  20382413     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Increased rates of bowel perforation in patients with recurrent epithelial ovarian cancer (EOC) treated with bevacizumab have been reported, but the risk factors for this association are uncertain. We sought to identify factors associated with bowel perforation and fistula formation in recurrent EOC patients treated with bevacizumab.
METHODS: A chart review of all patients treated with bevacizumab for recurrent EOC at a single institution was performed. Pertinent patient characteristics and treatment information were collected. Univariate logistic regression was performed to analyze multiple variables.
RESULTS: One hundred twelve patients who were treated with 160 different bevacizumab regimens were identified. The median age was 60 years (range, 29-78 years). Patients had received a median of 4 prior chemotherapy regimens (range, 1-10). The median number of cycles was 4 (range, 0.5-31). Ten patients (9%) were diagnosed with bowel perforations, and another 2 patients (1.8%) were diagnosed with fistulas. The 30-day mortality following perforation was 50%, with 30% of patients dying within 1 week. Patients with rectovaginal nodularity were more likely to develop a bowel perforation or fistula than those who did not have this finding, OR=3.64 (95% CI=1.1 to 12.1, p=0.04). None of the other variables were significantly associated with bowel perforations or fistula formation.
CONCLUSIONS: Rectovaginal nodularity is associated with an increased risk of bowel perforation or fistula formation for patients with recurrent EOC treated with bevacizumab. Careful consideration should be given prior to initiating bevacizumab treatment in EOC patients with rectovaginal nodularity since the mortality rate with bevacizumab associated bowel perforations is 50%.
D L Richardson; F J Backes; J D Hurt; L G Seamon; L J Copeland; J M Fowler; D E Cohn; D M O'Malley
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Publication Detail:
Type:  Journal Article     Date:  2010-04-10
Journal Detail:
Title:  Gynecologic oncology     Volume:  118     ISSN:  1095-6859     ISO Abbreviation:  Gynecol. Oncol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-14     Completed Date:  2010-06-22     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  0365304     Medline TA:  Gynecol Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  47-51     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, M-210 Starling Loving Hall, 320 West 10th Avenue, Columbus, OH 43210, USA.
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MeSH Terms
Angiogenesis Inhibitors / administration & dosage,  adverse effects
Antibodies, Monoclonal / administration & dosage,  adverse effects*
Antibodies, Monoclonal, Humanized
Antineoplastic Combined Chemotherapy Protocols / administration & dosage,  adverse effects*
Epithelial Cells / pathology
Fallopian Tube Neoplasms / drug therapy,  pathology
Intestinal Perforation / chemically induced*,  pathology
Middle Aged
Neoplasm Recurrence, Local / drug therapy*,  pathology
Ovarian Neoplasms / drug therapy*,  pathology
Peritoneal Neoplasms / drug therapy,  pathology
Retrospective Studies
Risk Factors
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 2S9ZZM9Q9V/bevacizumab

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