A prospective outcomes analysis of palliative procedures performed for malignant intestinal obstruction due to recurrent ovarian cancer.
OBJECTIVE
To obtain prospective outcomes data on patients (pts) undergoing palliative operative or endoscopic procedures for malignant bowel obstruction due to recurrent ovarian cancer.


METHODS
An institutional study was conducted from July 2002 to July 2003 to prospectively identify pts who underwent an operative or endoscopic procedure to palliate the symptoms of advanced cancer. This report focuses on pts with malignant bowel obstruction due to recurrent ovarian cancer. Procedures performed with an upper or lower gastrointestinal (GI) endoscope were considered "endoscopic." All other cases were classified as "operative." Following the procedure, the presence or absence of symptoms was determined and followed over time. All pts were followed until death.


RESULTS
Palliative interventions were performed on 74 gynecologic oncology pts during the study period, of which 26 (35%) were for malignant GI obstruction due to recurrent ovarian cancer. The site of obstruction was small bowel in 14 (54%) cases and large bowel in 12 (46%) cases. Palliative procedures were operative in 14 (54%) pts and endoscopic in the other 12 (46%). Overall, symptomatic improvement or resolution within 30 days was achieved in 23 (88%) of 26 patients, with 1 (4%) postprocedure mortality. At 60 days, 10 (71%) of 14 pts who underwent operative procedures and 6 (50%) of 12 pts who had endoscopic procedures had symptom control. Median survival from the time of the palliative procedure was 191 days (range, 33-902) for those undergoing an operative procedure and 78 days (range, 18-284) for those undergoing an endoscopic procedure.


CONCLUSIONS
Patients with malignant bowel obstructions due to recurrent ovarian cancer have a high likelihood of experiencing relief of symptoms with palliative procedures. Although recurrence of symptoms is common, durable palliation and extended survival are possible, especially in those patients selected for operative intervention.
Chi
Dennis S
DS
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. gynbreast@mskcc.org
Phaëton
Rebecca
R
Miner
Thomas J
TJ
Kardos
Steven V
SV
Diaz
John P
JP
Leitao
Mario M
MM
Gardner
Ginger
G
Huh
Jae
J
Tew
William P
WP
Konner
Jason A
JA
Sonoda
Yukio
Y
Abu-Rustum
Nadeem R
NR
Barakat
Richard R
RR
Jaques
David P
DP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000150:complications*; D010166:Palliative Care / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult