A Retrospective Study of Patients Who Developed Gastrointestinal Perforation During Chemotherapy for Metastatic Colorectal Cancer

Abstract

INTRODUCTION: Gastrointestinal perforation caused by angiogenesis inhibitors administered as chemotherapy for metastatic colorectal cancer (mCRC) is a potentially fatal adverse event. OBJECTIVE: To determine the frequency of and most appropriate treatment for gastrointestinal perforation developing during chemotherapy for mCRC. METHODS: We retrospectively investigated the incidence of gastrointestinal perforation (CTCAE v3.0 Grade 3 or higher) developing in patients who received chemotherapy for mCRC at our center between January 2020 and February 2022. RESULTS: A total of 55 patients were included in the study. The median age was 63.5 (36-89) years, and the male/female ratio was 31/24; the PS at the start of chemotherapy was 0/1/2 in 44/9/2 cases. There were 2 (3.6％) cases of Grade 3 or higher gastrointestinal perforation. One of the patients was managed conservatively with antimicrobial agents, while the other was treated by surgery with omental plugging and drainage. Both patients had received treatment with angiogenesis inhibitors. There were no cases of treatment-related death. CONCLUSION: We report two cases of chemotherapy-induced gastrointestinal perforation: one of the patients was successfully managed conservatively, while the other required surgery.