Medical management of malignant bowel obstruction in patients with advanced cancer: 2021 MASCC guideline update

Davis, Mellar P.; Hui, David; Davies, Andrew; Ripamonti, Carla; Capela, Andreia; DeFeo, Giulia; Fabbro, Egidio Del; Bruera, Éduardo

doi:10.1007/s00520-021-06438-9

Cited by 19 publications

(4 citation statements)

References 59 publications

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“…Bowel obstruction can be caused by a variety of factors, including tumor growth compressing the gut, intra-luminally blocking masses, radiotherapy side effects, past surgery complications, or harsh medical treatment creating intestinal stenosis or occlusion. The goal of treatment should be to relieve abdominal distention, clear the blockage (restore bowel continuity and/or bypass the "obstacle"), and avoid consequences (dyselectrolytemia, bacterial overgrowth, and perforation) as well as respiratory distress (caused by increase of intra-abdominal pressure) [52]. Even while an intestinal stoma can be a source of additional trauma for oncological children and their parents, it can also help to improve the quality of life by providing a viable option for nutritional needs (through gastrostomy), bolus or continuous enteral feedings.…”

Section: Bowel Obstructionmentioning

confidence: 99%

Perspective Chapter: Palliative Surgery in Pediatric Cancer

Inserra¹,

Martucci²

2023

Supportive and Palliative Care and Quality of Life in Oncology

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Childhood can cer survival rates have lately improved (from 54% in 1980 to an actual 80%), and palliative care has taken on a larger role in the management of oncological kids, with many clinicians involved (including oncologists, radiologists, and surgeons). Palliative surgery has evolved from “noncurative” treatments to a variety of surgeries used to relieve organ dysfunction and provide the best possible quality of life in all aspects of life (clinical, psychological, and social).

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Section: Bowel Obstructionmentioning

confidence: 99%

Perspective Chapter: Palliative Surgery in Pediatric Cancer

Inserra¹,

Martucci²

2023

Supportive and Palliative Care and Quality of Life in Oncology

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“…The 2021 MASCC guideline about select pharmacologic management of nausea and vomiting in MBO was released in August 2021 as an update to a previous guideline published in 2017 [16]. The following sections and Appendix B provide suggestions/recommendations for all anti-emetic drug classes reportedly used for MBO management and their associated existing evidence:…”

Section: Anti-emeticsmentioning

confidence: 99%

MASCC multidisciplinary evidence-based recommendations for the management of malignant bowel obstruction in advanced cancer

Madariaga

Lau²,

Ghoshal³

et al. 2022

Support Care Cancer

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Purpose To provide evidence-based recommendations on the management of malignant bowel obstruction (MBO) for patients with advanced cancer. Methods The Multinational Association for Supportive Care in Cancer (MASCC) MBO study group conducted a systematic review of databases (inception to March 2021) to identify studies about patients with advanced cancer and MBO that reported on the following outcomes: symptom management, bowel obstruction resolution, prognosis, overall survival, and quality of life. The review was restricted to studies published in English, but no restrictions were placed on publication year, country, and study type. As per the MASCC Guidelines Policy, the findings were synthesized to determine the levels of evidence to support each MBO intervention and, ultimately, the graded recommendations and suggestions. Results The systematic review identified 17,656 published studies and 397 selected for the guidelines. The MASCC study group developed a total of 25 evidence-based suggestions and recommendations about the management of MBO-related nausea and vomiting, bowel movements, pain, inflammation, bowel decompression, and nutrition. Expert consensus-based guidance about advanced care planning and psychosocial support is also provided. Conclusion This MASCC Guideline provides comprehensive, evidence-based recommendations about MBO management for patients with advanced cancer.

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“…An obstruction can be mechanical (caused by the infiltration of a tumour) or functional (caused by a lack of motility), and can present as a singular blockage or multiple blockages caused by diffuse carcinomatosis. The wide range of definitions of the condition contribute to difficulties in establishing its incidence [6,7,8] . It is most prevalent in colorectal cancer, affecting up to 29 per cent of patients [9] , and in ovarian cancer, affecting up to up to 51 per cent of patients [6] .…”

Section: Introductionmentioning

confidence: 99%

“…The wide range of definitions of the condition contribute to difficulties in establishing its incidence. [6][7][8] It is most prevalent in colorectal cancer, affecting up to 29% of patients, 9 and in ovarian cancer, affecting up to up to 51% of patients. 6 The management of malignant bowel obstruction is complex and controversial.…”

Section: Introductionmentioning

confidence: 99%

The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review

et al. 2022

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Background: Malignant bowel obstruction, a complication of certain advanced cancers, causes severe symptoms which profoundly affect quality of life. Clinical management remains complex, and outcome assessment is inconsistent. Aim: To identify outcomes evaluating palliative treatment for inoperable malignant bowel obstruction, as part of a four-phase study developing a core outcome set. Design: The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); PROSPERO (ID: CRD42019150648). Eligible studies included at least one subgroup with obstruction below the ligament of Treitz undergoing palliative treatment for inoperable malignant bowel obstruction. Study quality was not assessed because the review does not evaluate efficacy. Data sources: Medline, Embase, the Cochrane Database, CINAHL, PSYCinfo Caresearch, Open Grey and BASE were searched for trials and observational studies in October 2021. Results: A total of 4769 studies were screened, 290 full texts retrieved and 80 (13,898 participants) included in a narrative synthesis; 343 outcomes were extracted verbatim and pooled into 90 unique terms across six domains: physiological, nutrition, life impact, resource use, mortality and survival. Prevalent outcomes included adverse events (78% of studies), survival (54%), symptom control (39%) and mortality (31%). Key individual symptoms assessed were vomiting (41% of studies), nausea (34%) and pain (33%); 19% of studies assessed quality of life. Conclusions: Assessment focuses on survival, complications and overall symptom control. There is a need for definitions of treatment ‘success’ that are meaningful to patients, a more consistent approach to symptom assessment, and greater consideration of how to measure wellbeing in this population.

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Medical management of malignant bowel obstruction in patients with advanced cancer: 2021 MASCC guideline update

Cited by 19 publications

References 59 publications

Perspective Chapter: Palliative Surgery in Pediatric Cancer

Perspective Chapter: Palliative Surgery in Pediatric Cancer

MASCC multidisciplinary evidence-based recommendations for the management of malignant bowel obstruction in advanced cancer

The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review

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