Does Bevacizumab Cause Headache to the Onco-Surgeon? An Evidence-Based Review with Experience from A Tertiary Care Referral Oncology Center, India

Introduction:Bevacizumab is an antibody against VEGF-A which has recently been used in the pre-operative setting in malignancies, specially colo-rectal and ovarian cancers.We aim to review the surgical complications associated with such use of this molecule.Methods: Cases of ovarian and colorectal cancers that received preoperative Bevacizumab and underwent surgery at our center were included and their postoperative complications were evaluated.A review of literature was done for evaluating the complications associated with Bevacizumab.Cases and review: Four such cases were evaluated, all of whom developed postoperative complications.Patients developed perforations, urinary fistulae and incisional hernia postoperatively.Bevacizumab is known to cause GI perforations, genitourinary fistulae and delayed wound healing and such complications have been known to have a poor impact on quality of life and survival.Conclusion: Patients who have received Bevacizumab as Neo-adjuvant Therapy, should be considered as a special entity.A minimum of 8 weeks' time interval before major surgery is recommended after stopping Bevacizumab.