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Palliative care in patients with ovarian cancer and bowel obstruction

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Abstract

Objective

Malignant bowel obstruction (MBO) is usually a pre-terminal event in patients with ovarian cancer. However, because of the lack of data in literature, decisions around surgical intervention, non-resectional procedures, or medical treatment of MBO in patients with ovarian cancer cannot be lightly undertaken. We analyzed medical and surgical procedures, performance status, nutritional status, cachexia, and their prognostic value in this group of patients.

Methods

We retrospectively selected all consecutive patients with recurrent ovarian cancer who received medical or surgical treatment for MBO between October 2008 and January 2014 at the Academic Department of Gynecological Oncology of Mauriziano Hospital of Turin (Italy).

Results

We found 40 patients: 18 of them underwent medical treatment and 22 of them were submitted to surgery. In the group of surgery, the hospitalization was shorter (p 0.02), the pain reduction was more effective (p 0.001), the number of chemotherapy lines was higher (p 0.03), and re-obstruction was more rare (p 0.02). Between the two groups, we did not find any differences in post-palliation episodes of vomit (p 0.83), type of diet (p 0.34), ability to return home (p 0.72), and death setting (p 0.28). Median survival after palliation was longer in the group of surgery (p 0.025). Cachexia, low performance status, and poor nutritional status were significant predictors of worse survival after MBO, independently by the treatment.

Conclusions

Surgery has to be considered in patients without serious contraindications; otherwise, a medical protocol, including antisecretory drugs, is the standard of care in frail patients.

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Conflict of interest

The authors have no financial and personal relationships with other people or organizations that could inappropriately influence this work. They have full control of all primary data, and they agree to allow the journal to review data if requested.

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Authors and Affiliations

  1. Academic Division of Gynecology and Obstetrics, Mauriziano Hospital, Via Magellano,1, 10128, Turin, Italy

    Alberto Daniele, A. Ferrero, L. Fuso, N. Biglia & G. Menato

  2. Department of Surgery, Mauriziano Hospital, Via Magellano,1, 10128, Turin, Italy

    M. Mineccia

  3. Service of Palliative Care, Mauriziano Hospital, Via Magellano,1, 10128, Turin, Italy

    V. Porcellana

  4. Service of Dietetics, Mauriziano Hospital, Via Magellano,1, 10128, Turin, Italy

    D. Vassallo

Authors
  1. Alberto Daniele
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  2. A. Ferrero
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  3. L. Fuso
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  4. M. Mineccia
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  5. V. Porcellana
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  6. D. Vassallo
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  7. N. Biglia
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  8. G. Menato
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Correspondence to Alberto Daniele.

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Daniele, A., Ferrero, A., Fuso, L. et al. Palliative care in patients with ovarian cancer and bowel obstruction. Support Care Cancer 23, 3157–3163 (2015). https://doi.org/10.1007/s00520-015-2694-9

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  • DOI: https://doi.org/10.1007/s00520-015-2694-9

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