Bowel Obstruction and Survival in Patients With Advanced Ovarian Cancer: Analysis of Prognostic Variables

Sartori, Enrico; Chiudinelli, Francesca; Pasinetti, Brunella; Maggino, T

doi:10.1111/igc.0b013e318198ff4b

Cited by 20 publications

(15 citation statements)

References 10 publications

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“…This is also in concordance with the recommendation by the European Association for Palliative Care that surgery should not be undertaken routinely in patients with poor performance status, intra-abdominal carcinomatosis, and massive ascites [ 47 ]. Only few reported series have investigated these clinical variables with mixed results, and it appears that collective assessment of the clinical variables into a risk-score system may be predictive of surgical outcome [ 4 , 10 , 56 – 58 ].…”

Section: Surgical Intervention For Mbomentioning

confidence: 99%

“…Ovarian cancer is the dominant cause of MBO and the most lethal of all gynecologic malignancies [ 1 – 5 ]. In reported retrospective series, up to 51% of women [ 3 – 6 ] with recurrent ovarian cancer developed MBO and their median survival following MBO diagnosis ranged from 45 to 169 days [ 4 , 5 , 7 – 9 ]. Median survival was longer (124–408 days) [ 5 , 7 – 10 ] for those selected patients who underwent palliative surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Malignant Bowel Obstruction in Advanced Gynecologic Cancers: An Updated Review from a Multidisciplinary Perspective

Lee

Jivraj

O’Brien

et al. 2018

Obstetrics and Gynecology International

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Malignant bowel obstruction (MBO) is a major complication in women with advanced gynecologic cancers which imposes a significant burden on patients, caregivers, and healthcare systems. Symptoms of MBO are challenging to palliate and result in progressive decompensation of already vulnerable patients with limited therapeutic options and a short prognosis. However, there is a paucity of guidelines or innovative approaches to improve the care of women who develop MBO. MBO is a complex clinical situation that requires a multidisciplinary approach to ensure the appropriate treatment modality and interprofessional care to optimally manage these patients. This review summarizes the current literature on the different approaches targeting MBO management including surgical intervention, chemotherapy, total parenteral nutrition, and pharmacological treatment. In addition, the impact of MBO management on patients' quality of life (QOL) is examined. This article focuses on the challenges in developing evidence-based treatment guidelines for MBO and barriers in clinical trial design for MBO and proposes strategies to advance the MBO management. Collaboration is essential to design studies that may improve the overall care and quality of life for these patients. Prospective data are needed to inform clinical practice, establish a new benchmark for evidence-based MBO management, and better understand the biology of MBO.

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Section: Surgical Intervention For Mbomentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Malignant Bowel Obstruction in Advanced Gynecologic Cancers: An Updated Review from a Multidisciplinary Perspective

Lee

Jivraj

O’Brien

et al. 2018

Obstetrics and Gynecology International

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“…These rates of bowel obstruction appear somewhat comparable to those reported by others. 3,4 However, the fact that 142 (45%) patients were lacking information on morbidity prior to death or after last follow-up raises concern that the rate of documented bowel obstruction reported here and in previous reports may, in fact, represent an underestimate.…”

Section: Discussionmentioning

confidence: 56%

“…The purpose of that study was to define risk scores to predict patient outcomes to identify the most appropriate palliative intervention for an obstructed patient. 4 These 2 studies have contributed substantially to the published literature on this topic of bowel obstruction in patients with ovarian cancer, providing a rate of 20% to 28% and appearing to mitigate the concern voiced by Jayson and others that bowel obstruction is ''the most frequent single cause of death'' in patients with ovarian cancer. 2 Nonetheless, several unanswered questions remain.…”

mentioning

confidence: 99%

Malignant Bowel Obstruction in Patients With Recurrent Ovarian Cancer

Tran

Spiceland

Sandhu

et al. 2014

Am J Hosp Palliat Care

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We sought to report incidence, risk factors, and survival related to bowel obstruction in 311 ovarian cancer patients with recurrent disease. A total of 68 (22%) had a documented bowel obstruction during their cancer course, and 49 (16%) developed it after cancer recurrence. Surprisingly, 142 (45%) fit into an “unknown” category (3+ months of data lacking from last contact/death). No risk factors were identified; management included surgery (n = 21), conservative measures (n = 21), and other (n = 7). Documented bowel obstruction was not associated with a statistically significant reduction in survival after cancer recurrence. In conclusion, although bowel obstruction occurs in only a subgroup of patients with ovarian cancer and does not appear to detract from survival after cancer recurrence, limited end-of-life information may be resulting in an underestimation of incidence.

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“…Perhaps surprisingly, there is disagreement as to whether a prior response to (platinum‐based) chemotherapy is a predictor of successful palliation . According to one report, the interval from the initial diagnosis of ovarian cancer to bowel obstruction was a predictor of survival and other variables reportedly associated with unsuccessful surgical palliation, included low haematocrit levels, high alkaline phosphatase levels poor nutritional status and previous radiotherapy . In one study, both the serum albumin level and ascites were predictors of surgical success .…”

Section: Role Of Surgerymentioning

confidence: 99%

Surgical management of bowel obstruction in gynaecological cancer

Kolomainen

Riley

Wood

et al. 2017

The Obstetric & Gynaecologis

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Bowel obstruction in gynaecological cancers requires a multidisciplinary approach to optimise patient outcomes. Surgery is usually performed with palliative intent. The palliative care team should be involved in patient management especially in the case of recurrent disease. There is no level 1 evidence or national guidance available. Learning objectivesTo understand that bowel obstruction in women with gynaecological cancer is rare and seen more often with recurrent disease than primary disease. To appreciate that case selection for surgery is individualised, and that surgery is associated with higher morbidity and mortality rates in emergency cases and following radiotherapy or recent chemotherapy. Most women with gynaecological cancer present with non-acute bowel obstruction, which is most commonly associated with recurrent epithelial ovarian cancer among gynaecological cancers.Bowel obstruction in irradiated women is less often caused by recurrent cancer. Conservative management includes drug treatments such as opiates, anticholinergics and steroids. Ethical issuesData on the quality of life of women with gynaecological cancer and bowel obstruction are lacking. Although the goal is palliation in most women, there is no clear definition of 'successful palliation'. Surgical intervention does not always provide sustained palliation, yet it can contribute to increased morbidity and mortality.

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Bowel Obstruction and Survival in Patients With Advanced Ovarian Cancer: Analysis of Prognostic Variables

Cited by 20 publications

References 10 publications

Malignant Bowel Obstruction in Advanced Gynecologic Cancers: An Updated Review from a Multidisciplinary Perspective

Malignant Bowel Obstruction in Advanced Gynecologic Cancers: An Updated Review from a Multidisciplinary Perspective

Malignant Bowel Obstruction in Patients With Recurrent Ovarian Cancer

Surgical management of bowel obstruction in gynaecological cancer

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