Annals of Surgical Oncology

, Volume 19, Issue 4, pp 1326–1333 | Cite as

Feasibility of Surgery After Systemic Treatment with the Humanized Recombinant Antibody Bevacizumab in Heavily Pretreated Patients with Advanced Epithelial Ovarian Cancer

  • Jalid Sehouli
  • G. Papanikolaou
  • E.-I. Braicu
  • K. Pietzner
  • P. Neuhaus
  • C. Fotopoulou
Gynecologic Oncology



The aim of this study was to assess operative feasibility and outcome after bevacizumab treatment (BT) in ovarian cancer (OC) patients.

Patients and Methods

We retrospectively identified all OC patients operated between April 2006 and September 2010 after BT.


We identified 733 OC operations, 10 of which (1.36%) were performed in a mean time of 134 days (range, 10–288) after BT. Indication was secondary cytoreduction in 3 patients (mean days after BT, 181; range, 82–256) and palliation in 7 due to bowel obstruction and/or intestinal perforation or fistula (mean days after BT, 114; range, 10–288). All but 1 acutely operated patients developed a secondary wound healing, but none of the 3 patients after planned cytoreduction did. Of these 3 patients, 1 suddenly died on the 36th postoperative day, presumably of thromboembolism. None of the patients developed postoperatively a gastrointestinal morbidity; however, in 1 patient operated 21 days after BT due to a vesicointestinal fistula the bladder reconstruction could not heal and developed a permanent fistula.


Emergency surgery after BT due to bowel obstruction and/or fistulas seems to be associated with an impaired wound healing in advanced heavily pretreated platinum-resistant OC patients, while this does not appear the case in planned cytoreduction. Prospective evaluations are warranted to assess surgical safety after BT in this special patients’ collective.


Bevacizumab Ovarian Cancer Patient Short Bowel Syndrome Recurrent Ovarian Cancer Bevacizumab Treatment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Jalid Sehouli
    • 1
  • G. Papanikolaou
    • 1
  • E.-I. Braicu
    • 1
  • K. Pietzner
    • 1
  • P. Neuhaus
    • 2
  • C. Fotopoulou
    • 1
  1. 1.Department of Gynecology, European Competence Centre for Ovarian CancerCharité-University HospitalBerlinGermany
  2. 2.Department of General, Visceral, and Transplantation SurgeryHumboldt UniversityVirchow KlinikumGermany

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