Patient: I have colon cancer, and stenting after three courses of chemotherapy, (the first two oxaliplatin plus capecitabine now irinotecan plus 5fu) the posterior vaginal fornix gouge to nodules, from the colon, pelvic metastases (four times imaging suggests cystic adenoma) pet and other CT suggests no abdominal metastases. Genetic testing krastp53 mutation now colon with stent, have not been too afraid to eat, please ask if laparoscopic exploration without abdominal metastases can be operated? The tumor load is too large. Because of the placement of the stent, the treating doctor is afraid to use bevacizumab. Case study]: This is a case that is worth discussing. I say it is worthy of discussion because the treatment plan is likely to be inconsistent from one doctor to another. The patient had colon cancer obstruction with bilateral ovarian metastasis and suspected peritoneal metastasis. The patient was placed a stent for dilatation because of the obstruction. However, after stent placement, her primary care physician did not use the targeted drug bevacizumab because of concerns about perforation. There is some justification for this concern, as side effects of bevacizumab include bleeding, perforation, and other problems. The controversial aspects of this patient’s treatment: whether to consider surgery and whether surgery is worthwhile. Opinion 1: Surgery is not needed. Reason: The patient has an advanced tumor with no possibility of radical surgical resection. The stent has been placed and there is no obstruction, at least for now, so surgery is not needed. Continued chemotherapy is sufficient for maintenance. Viewpoint 2: Consider surgery to remove the primary lesion and stent, and also remove both ovaries and tumor. Rationale: Although the patient is advanced, colon cancer ovarian metastasis, removal of ovarian metastases and primary foci can improve survival to some extent. Reducing the tumor load and continuing drug therapy after surgery may have better results. In addition, resection of stent can be safely combined with bevacizumab, without worrying about bleeding and perforation. Also, the stent is only a temporary expansion, and there is a high probability that it will be obstructed again later, and surgery will still be needed to solve the problem then. However, as the tumor progresses, the chance of surgical resection may be lost, and we can only hope for the “tumor”. Furthermore, intraoperative and postoperative chemotherapy can be combined with intraperitoneal thermal perfusion to provide an opportunity for further tumor control. Therefore, considering the patient’s age (young) and physical condition, the second viewpoint is recommended.