Management of bowel obstruction in patients with advanced ovarian cancer.
In a retrospective study, 58 patients with bowel obstruction due to advanced ovarian cancer were analysed. In a forward stepwise proportional hazard regression analysis, we looked for factors influencing bowel obstruction-free survival. Patients who presented with bowel obstruction as the first sign of ovarian cancer and those with a longer interval between last cancer treatment and bowel obstruction did better. Patients with ascites did worse. No other independent factors were found. Based on these data, we classified patients into a favourable prognosis group (no previous treatment or interval since last treatment exceeding 6 months; no ascites) and a poor prognosis group (interval since last treatment shorter than 6 months; ascites). Patients from the favourable prognosis group had a median bowel obstruction-free survival of 8 months, compared to 1 month for the poor prognosis group (P < 0.001). Surgery had a marginally significant positive effect on bowel obstruction-free survival when compared to medical treatment in the favourable prognosis group (P = 0.052). Surgery had no effect at all in the poor prognosis patients.
Department of Surgery, Netherlands Cancer Institute, Amsterdam.
F A
FA
Zoetmulder
T J
TJ
Helmerhorst
F
F
van Coevorden
P E
PE
Wolfs
J P
JP
Leyer
A A
AA
Hart
D000328:Adult; D000368:Aged; D001201:Ascites / Q000150:complications; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D007422:Intestines / Q000601:surgery; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications* / Q000401:mortality; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D013997:Time Factors