Malignant Bowel Obstruction in Relapsed Ovarian Cancer With Peritoneal Carcinomatosis: An Occlusive State

Castro, Pedro Martínez; Vargas, Lara; Mancheño, Antonio; Utrilla, Salvador Martín; Pascual, Francisco; Romero, Ignacio; Zorrero, Cristina; Bosch, José Manuel; Poveda, Andrés; Minig, Lucas

doi:10.1097/igc.0000000000001049

Cited by 18 publications

(7 citation statements)

References 18 publications

(19 reference statements)

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“…Median survival was longer (124–408 days) [ 5 , 7 – 10 ] for those selected patients who underwent palliative surgical intervention. Majority of these women would experience recurrent episodes of MBO over their short life expectancy [ 11 ].…”

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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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: 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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“…The natural history of these malignancies can be vastly different within their own disease type (i.e. low‐grade versus high‐grade tumours) and as such management techniques should be appropriately geared to each individual disease 42 . The above‐mentioned population of patients is heterogeneous across numerous hospital centres, countries, disease processes and across decades of time.…”

Section: Discussionmentioning

confidence: 99%

Management of primary and metastatic malignant small bowel obstruction, operate or palliate. A systematic review

Banting

Waters

Peacock

et al. 2020

ANZ Journal of Surgery

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Background The management of patients presenting with malignant small bowel obstruction is a challenging paradigm. The aim of this systematic review was to examine different management strategies in these complex patients. The primary outcomes evaluated were the type of intervention, 30‐day morbidity and mortality and overall survival rates. Methods A systematic literature review of EMBase, Medline, PubMed and the Cochrane Library was performed using Preferred Reporting Items for Systematic reviews and Meta‐Analyses for studies reporting on conservative and operative management of malignant small bowel obstruction. Results Fifteen studies (n = 882 patients) reporting on outcomes for malignant small bowel obstruction were analysed. Outcomes measured were primarily survival and relief of obstructive symptoms. The median age ranged from 52 to 66 years. The most common cause of malignant small bowel obstruction was gynaecological in nature (56%), followed by colorectal (19%). Four hundred and eighty‐six patients underwent primary surgical management and the remaining 396 patients were assigned to non‐surgical intervention. Median overall survival in the operative studies ranged from 2.5 to 7.4 months compared with 0.9 to 1.9 months (P < 0.05). The 30‐day mortality ranged from 13% to 28% in those who underwent surgical interventions versus 2% to 61% in the non‐surgical group (P = 0.09). No significant difference in median survival in gastrointestinal (GI) and gynaecological malignancies was observed (4.3 versus 5.0 months, P = 0.12). Morbidity ranged from 21% to 85% in the surgical group and 12% to 29% in the percutaneous groups (P < 0.05). Conclusion Surgical intervention in malignant small bowel obstruction is associated with significant morbidity, although it may improve survival in selected patients with gynaecological and colorectal malignancy. It is imperative that realistic goals and expectations are discussed with patients preoperatively.

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“…Patients were also grouped into those with a median OS time of 90 days or below, and those with a median OS time above 90 days. 12 Comparisons between groups were made with t test, Mann-Whitney test, or Wilcoxon test and χ 2 test, as appropriate. Receiver operating characteristic (ROC) curves were generated for statistically significant variables on univariate analysis to evaluate their diagnostic ability to predict shorter survival.…”

Section: Methodsmentioning

confidence: 99%

Prognostic CT findings of malignant bowel obstruction in patients with advanced ovarian cancer

Miccò

Sbarra

Gui

et al. 2019

Tumori

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Objective: To evaluate computed tomography (CT) findings able to predict outcome in patients with ovarian cancer (OC) and concomitant bowel occlusion. Methods: This institutional review board–approved retrospective study included 31 patients with OC and clinical evidence of bowel occlusion who underwent CT at presentation between February 2013 and June 2015. Two radiologists recorded various qualitative CT features. Correlations between CT and survival data were made with Mann-Whitney test, Wilcoxon test, and χ2 test, as appropriate. Receiver operating characteristic curves were generated for statistically significant CT findings using logistic regression model. Results: Two of 31 patients (6.5%) were alive at the end of this study; 29 patients (93.5%) died of disease. Median overall survival was 90 days. CT features associated with short life expectancy were bowel mural thinning ( p=0.03), mesenteric tumor deposits ( p=0.009), mesenteric infiltration ( p=0.02), and ascites ( p=0.04). Area under the curve was 0.728 ( p=0.03) for mesenteric tumor deposits in predicting malignant bowel obstruction. Conclusions: Accurate interpretation of CT features may guide decisions in care of women with OC and bowel obstruction.

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Malignant Bowel Obstruction in Relapsed Ovarian Cancer With Peritoneal Carcinomatosis: An Occlusive State

Cited by 18 publications

References 18 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

Management of primary and metastatic malignant small bowel obstruction, operate or palliate. A systematic review

Prognostic CT findings of malignant bowel obstruction in patients with advanced ovarian cancer

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