Annals of Surgical Oncology

, Volume 17, Issue 3, pp 853–860

Role of Computed Tomography in the Surgical Management of Patients with Bowel Obstruction Secondary to Recurrent Ovarian Carcinoma

  • J. Alejandro Rauh-Hain
  • Alexander B. Olawaiye
  • Elizabeth G. Munro
  • Emily Ko
  • Irma A. Alarcon
  • Marcela G. Del Carmen
  • Linda Duska
Gynecologic Oncology

DOI: 10.1245/s10434-009-0813-x

Cite this article as:
Alejandro Rauh-Hain, J., Olawaiye, A.B., Munro, E.G. et al. Ann Surg Oncol (2010) 17: 853. doi:10.1245/s10434-009-0813-x

Abstract

Background

The purpose of this study was to evaluate the potential role of preoperative computed tomography (CT) and clinical features for predicting the outcome of patients with bowel obstruction secondary to ovarian cancer.

Materials and Methods

We identified a subpopulation of patients admitted to the Massachusetts General Hospital for bowel obstruction caused by recurrent ovarian cancer from January 1, 1995, to August 1, 2007. A retrospective review of 10 clinical features and 6 radiographic findings was performed. These findings were analyzed as variables with probable prognostic influence on survival and ability to predict successful palliation, defined as the ability to tolerate a regular or low-residue diet 60 days after discharge. Statistical significance was evaluated using the Fisher exact test. Univariate analysis was done by constructing probability curves according to the Kaplan–Meier method and comparing them by the log-rank test.

Results

The study population consisted of 55 patients. Absence of carcinomatosis on CT scan and albumin ≥3 g/dL were found to be able to predict successful palliation. Platinum resistance, albumin ≥3 g/dL, and peritoneal carcinomatosis on CT scan were identified as variables with prognostic influence on survival in the univariate analysis. In the Cox regression analysis, only the absence of CT findings of carcinomatosis (P = .009) and albumin ≥ 3 g/dL (P = .05) were independently associated with survival.

Conclusions

CT scan seems to be helpful in patients with a solitary site as the cause of bowel obstruction. All the patients in our study with this finding had a successful palliation. On the other hand, successful palliation is still feasible in the presence of peritoneal carcinomatosis on CT scan; therefore, this finding alone should not be the reason to avoid surgery in well-selected patients.

Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • J. Alejandro Rauh-Hain
    • 1
  • Alexander B. Olawaiye
    • 2
  • Elizabeth G. Munro
    • 1
  • Emily Ko
    • 1
  • Irma A. Alarcon
    • 3
  • Marcela G. Del Carmen
    • 1
  • Linda Duska
    • 4
  1. 1.Division of Gynecologic Oncology, Vincent Obstetrics and GynecologyMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Division of Gynecologic OncologyMagee-Women’s Hospital, University of Pittsburgh Medical CenterPittsburghUSA
  3. 3.Department of MedicineTufts University School of Medicine, St. Elizabeths Medical CenterBostonUSA
  4. 4.Division of Gynecologic OncologyUniversity of VirginiaCharlottesvilleUSA

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