Gynécologie & Obstétrique
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Bevacizumab Treatment for Recurrent Ovarian Cancer with Isolated Metastasis to the Lymph Node

Kenro Chikazawa, Sachiho Netsu, Keiko Akashi, Yurina Suzuki, Daisuke Hotta and Ryo Konno

Bevacizumab (BV) has been used as an effective treatment option for advanced and recurrent cancers; however there are no reports till date on its usage in ovarian cancers with isolated metastasis to the lymph node. Here, we present two cases of ovarian cancer (OVCA) recurrence with isolated metastasis to the lymph node that showed complete response (CR) to BV. In the first case, a 60-year-old woman with OVCA, FIGO stage Ic(b), clear cell adenocarcinoma, exhibited recurrence of the disease with isolated metastasis to the right internal iliac lymph nodes approximately after a year. Eight cycles of paclitaxel/carboplatin therapy resulted in stable disease (SD) and six cycles of docetaxel/carboplatin/BV therapy resulted in CR in the patient without adverse effects. In the second case, a 34-year-old woman who presented with OVCA, FIGO stage IIIc, showed recurrence of ovarian cancer with periportal and external iliac lymph node metastasis after a year which showed CR with paclitaxel/carboplatin combination chemotherapy. Further recurrences in this patient with portal artery metastasis and hilar lymph node metastasis were treated with irinotecan/nedaplatin with surgery and adjuvant therapy and surgery respectively, resulting in SD. Recurrence with para-aortic and obturator lymph node metastasis was noted further, which was treated with 6 cycles of paclitaxel/carboplatin/BV therapy, resulting in CR without adverse effects. Hence, BV might be effective for OVCA recurrence with isolated metastasis to the lymph node and is useful in such cases with no dissemination refractory to prior regimens.