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Outcome prognostic factors in inoperable malignant bowel obstruction

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Abstract

Purpose

Inoperable malignant bowel obstruction (MBO), a severe complication of peritoneal carcinomatosis, has a low desobstruction rate (30–40 %) and end-of-life decision-making is hampered by the lack of known prognostic factors. This study aimed to explore prognostic factors for desobstruction in MBO.

Methods

All patients with inoperable MBO admitted in our large oncology hospital between 2010 and 2013 were treated following a clinical protocol based on antiemetics, steroids and two antisecretories, octreotide, and hyoscine butylbromide. Two prognostic factor analyses using logistic regressions were performed, one based on data from day 1 of admission and the other on data from day 8.

Results

Forty-five patients were included. Frequency of desobstruction was 48.9 %. In the analysis of prognostic factors on day 1, MBO episodes derived from functional physiopathologic mechanisms (vs. mechanic or mixed) were more prone to resolve (p < 0.001 corrected for multiple comparisons). Considering patients alive with persistent obstruction on day 8, a better clinical condition was the variable more associated with desobstruction, but without statistical significance after correction for multiple comparisons.

Conclusions

A functional physiopathologic mechanism of MBO development may be an early prognostic factor for desobstruction. A high proportion of desobstruction was observed, suggesting that the combination of antisecretories with different mechanism of action warrants further investigation.

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Author information

Author notes

  1. Alberto Indacochea

    Present address: Center for Genomic Regulation (CRG), Vall d’Hebron Institut de Recerca, Barcelona, Spain

  2. Núria Pardo

    Present address: Medical Oncology Department, Hospital Vall d’Hebron, Vall d’Hebron Institut of Oncology, Barcelona, Spain

Authors and Affiliations

  1. Medical Oncology Department, Institut Català d’Oncologia, Carretera del Canyet s/n, 08916, Badalona, Spain

    Margarita Romeo, Maria de los LLanos Gil, José Luís Cuadra Urteaga, Laia Vilà, Sara Ahlal, Alberto Indacochea, Núria Pardo & Albert Font

  2. Universitat Autónoma de Barcelona, Barcelona, Spain

    Margarita Romeo

  3. FIDMAG Germanes Hospitalàries- CIBERSAM, Sant Boi de Llobregat, Spain

    Joaquim Radua

  4. Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden

    Joaquim Radua

  5. Supportive Care in Cancer Unit, Medical Oncology Department, Hospital Clínic de Barcelona, Barcelona, Spain

    Albert Tuca

Authors
  1. Margarita Romeo
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  2. Maria de los LLanos Gil
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  3. José Luís Cuadra Urteaga
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  4. Laia Vilà
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  5. Sara Ahlal
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  6. Alberto Indacochea
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  8. Joaquim Radua
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  9. Albert Font
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  10. Albert Tuca
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Corresponding author

Correspondence to Margarita Romeo.

Ethics declarations

All procedures were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Conflict of interest

The authors declare no conflicts of interest. No funding was required for this work.

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Romeo, M., de los LLanos Gil, M., Cuadra Urteaga, J.L. et al. Outcome prognostic factors in inoperable malignant bowel obstruction. Support Care Cancer 24, 4577–4586 (2016). https://doi.org/10.1007/s00520-016-3299-7

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  • DOI: https://doi.org/10.1007/s00520-016-3299-7

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