Palliative care in patients with ovarian cancer and bowel obstruction

Abstract

ABSTRACT

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

“…A systematic review of 868 patients with MBO showed that surgery was able to palliate obstructive symptoms (32–100%), enable resumption of a modified diet (45–75%), and facilitate successful patient discharge to home (34–87%) [ 54 ]. Similar results were found in another study examining treatment outcome for MBO under a multidisciplinary care model [ 10 ]. Compared to patients who received medical treatment, the surgical group had longer median survival ( p =0.025), shorter hospitalization ( p =0.02), more effective pain reduction ( p =0.001), higher number of chemotherapy lines ( p =0.02), and lower reobstruction rate ( p =0.02) [ 10 ].…”

“…Similar results were found in another study examining treatment outcome for MBO under a multidisciplinary care model [ 10 ]. Compared to patients who received medical treatment, the surgical group had longer median survival ( p =0.025), shorter hospitalization ( p =0.02), more effective pain reduction ( p =0.001), higher number of chemotherapy lines ( p =0.02), and lower reobstruction rate ( p =0.02) [ 10 ]. A prospective outcome analysis was performed on 26 patients with ovarian cancer who had undergone palliative procedures, including bowel diversion surgery ( n =8), intestinal bypass/resection ( n =6), and endoscopic procedures ( n =12) [ 9 ].…”

“…Surgical intervention can be successful in reestablishing bowel function for selected MBO patients with good functional status and treatment options for the underlying cancer [ 10 , 18 , 48 ]. Large bowel obstruction is associated with significant morbidity and risk of perforation and death, and conservative management is not usually appropriate in this setting.…”

“…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. Majority of these women would experience recurrent episodes of MBO over their short life expectancy [ 11 ].…”

Sarcopenia in Advanced Serous Ovarian Cancer

“…3 Although cachexia has long been acknowledged as a cardinal symptom of advanced ovarian cancer, 16 evidence on its actual prevalence are scarce, estimated somewhere in the lower to middle 2-digit range (36%Y40%), and there is hardly any information on its prevalence at the onset of disease. 27,28 The cohort of patients for whom body composition data at time of first diagnosis was available is listed separately. Brackets indicate percentage (%) if not indicated otherwise.…”