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Abstract
Objective
The
objective of this study was to evaluate peri-operative and survival
outcomes of ovarian cancer patients undergoing percutaneous upper
gastrointestinal decompression for malignant bowel obstruction (MBO).
Methods
Retrospective
chart review was used to identify patients with ovarian, peritoneal, or
fallopian tube cancer who underwent palliative decompressive treatment
for MBO from 1/2002 to 12/2010. Kaplan–Meier methods were used to
estimate the median survival (MS) and multivariate analysis used to
determine if any variables were associated with the hazard of death.
Results
Fifty-three
patients met inclusion criteria. Median length of diagnosis prior to
intervention was 21 months. Fifteen (28.3%) patients experienced
complications and 9 required revision. Forty-nine (92.5%) experienced
relief of symptoms after placement, and 91% tolerated some form of oral
intake. Following placement, 19 (36%) patients received additional
chemotherapy and 21(41%) patients received total parental nutrition
(TPN). Thirty-five patients were discharged home/outpatient facility, 16
to hospice care, and 2 died prior to discharge. MS for all patients was
46 days. Patients who received chemotherapy had a MS of 169 days
compared to 33 days (p < 0.001). We failed to find an association
between survival and TPN or performance status.
Conclusions
Malignant
bowel obstruction is a common complication of ovarian cancer.
Management is palliative; risks and benefits of any therapy must be
considered. Percutaneous decompressive therapy provides relief from
associated symptoms, and allows patients to be discharged home. Median
survival in this group is limited, and decisions regarding aggressive
therapy should be individualized.
Highlights
►
PDT is a safe and effective option for symptom management in ovarian
cancer patients with MBO.
► The use of chemotherapy following PDT was associated with an improved overall survival.
► As median survival is 46 days, aggressive therapy after PDT placement should be individualized.
► The use of chemotherapy following PDT was associated with an improved overall survival.
► As median survival is 46 days, aggressive therapy after PDT placement should be individualized.
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