Bowel obstruction in patients with ovarian cancer: A search for prognostic factors

Outcomes of palliative bowel surgery for malignant bowel obstruction in patients with gynecological malignancy

“…Zoetmulder et al also reported that the interval between last treatment and bowel obstruction, followed by the presence of ascites, was the most significant prognostic factor for MBO in ovarian cancer, discussing the implication of a long interval reflecting differences in the biology of relatively slow-growing tumors (3). A short interval between the diagnosis of primary cancer and bowel obstruction correlated with lower survival probabilities, according to Fernandes et al (2). In our cases, the time from primary therapy to diagnosis of MBO was longer in the operative and successful groups when compared with their opponents, but was not statistically significant, similar to the result reported by Zoetmulder et al (3).…”

“…This often results in poor quality of life and prolonged hospitalization at the end of life. Several prognostic factors for malignant bowel obstruction (MBO) have been reported to date, including age, performance status, nutritional status, ascites, palpable mass, extraabdominal metastasis and previous anticancer treatment (1)(2)(3)(4)(5). Although there have been increased efforts in the integration of palliative care, clinicians are in need of clinical data to guide towards more evidence-based practice.…”

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

“…Survival was significantly correlated to age and to interval from initial diagnosis to bowel obstruction in the series of Fernandes et al 4 Rubin et al 9 concluded that none of the multiple clinical variables analyzed correlated with survival after definitive surgery. In the series of Larson et al, 10 survival time was not significantly related to the presence or absence of tumor at obstruction, type of intervention, whether medical or surgical, patient age, or interval from initial diagnosis of ovarian cancer to obstruction.…”

“…Fifteen variables were selected for survival analysis: age, interval from initial diagnosis to obstruction, nutritional assessment (weight changes, hematocrit, serum albumin concentrations, total lymphocyte count), performance status by Karnowfsky (PSK), type of previous operations (standard primary surgery, others: interval surgery, secondary debulking, second look procedure), previous radiation therapy (RT), previous chemotherapy, tumor status (palpable or no palpable intra-abdominal masses), the presence of ascites, site of obstruction (small and/or large bowel), the presence or absence of vomiting, and pain as main symptoms. Those parameters had been independently suggested by Krebs and Goplerud, 3 Fernandes et al, 4 and Jong et al 5 The assignment of a score of 0 to 2 to each risk factor was based on the criteria proposed by Krebs and Goplerud 3 and the results in a new proposed risk score, based on 15 criteria that had to be proven to be predictive of prognosis. The parameter pain was only scored as present (2) or absent (0).…”

Surgical management of malignant bowel obstruction: Strategies toward palliation of patients with advanced cancer

“…Risk factors include advanced age, nutritional status, performance status, and concurrent comorbidities. Prior therapy, including surgery, radiation, and chemotherapy, all affect what a patient may tolerate and mediate the risk even further, which has been observed in numerous studies in patients with ovarian and colorectal cancers [11][12][13][14][15]. One could argue that it is unfair to use traditional end points such as morbidity and mortality to determine benefi t in this unique group of patients, especially if the goal is to palliate symptoms at the end of life.…”