Outcomes following small bowel obstruction due to malignancy in the national audit of small bowel obstruction

Drake, Thomas M; Lee, Matthew J.; Sayers, Adele E.; Abercrombie, John; Acheson, Austin G; Alderson, Derek; Anderson, I. 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doi:10.1016/j.ejso.2019.07.014

Cited by 13 publications

(3 citation statements)

References 24 publications

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“…MBO symptoms usually start gradually and become more frequent and severe when a complete obstruction occurs. Re-obstruction and malnutrition are common, with malnutrition being an independent predictor of poor survival in this population [5][6][7][8].…”

Section: Pathophysiology and Symptomsmentioning

confidence: 99%

“…Patients admitted with acute onset of an MBO are made nil by mouth with the addition of a decompressive procedures to control symptoms such as nausea and vomiting [2,107,108]. Managing the nutrition requirements of patients presenting with advanced cancers and MBO is controversial and ethically challenging as there is no consensus due to scant published evidence [5,109,110]. Nutrition interventions must be considered in the context of the patient's prognosis with the focus on prioritising the patient's wishes [111].…”

Section: • Nutrition Interventions Should Be Initiated In Patients Wi...mentioning

confidence: 99%

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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.

show abstract

Section: Pathophysiology and Symptomsmentioning

confidence: 99%

Section: • Nutrition Interventions Should Be Initiated In Patients Wi...mentioning

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

View full text Add to dashboard Cite

show abstract

“…Gastric cancer relapse and survival are largely attributed to tumor biology, aggressiveness, and the radicality of the surgery, but other prognostic factors have also been reported, including a pre-operative systemic inflammatory response 4 and post-operative morbidity 2,5 . In addition to higher recurrence rates, patients who develop post-operative morbidity, experience longer hospital stays and poor quality of life.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of compound combined peri-operative biomarkers in gastric cancer

Powell

Coxon

Robinson

et al. 2020

Preprint

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Objective: Survival after gastric cancer surgery is largely attributed to tumor biology, neoadjuvant chemotherapy (NAC), and surgical approach, yet other prognostic factors have been reported, including pre-operative systemic inflammatory response (SIR), and Morbidity Severity Score (MSS). The hypothesis tested was that a SIR, MMS, and pathological composite score, would be associated with disease-free (DFS) and overall survival (OS). Methods: Consecutive 358 patients undergoing potentially curative gastrectomy for adenocarcinoma were studied. Complications were defined as a MSS of Clavien-Dindo classification (CDSC) >1. Serum SIR measurements were performed on the day before surgery, and a composite score (CIMpN) (0-3) was developed based on CRP, morbidity, and pN-stage. Primary outcome measures were DFS and OS. Results: Post-operative complications occurred in 138 (38.5%) patients, (8 (2.2%) deaths), and was associated with higher CRP (28.3% vs. 15.5%, p=0.003), vascular invasion (55.8% vs. 36.8%, p<0.001), and R1 status (26.1% vs. 9.5%, p=0.001). Five-year DFS and OS were 32.9% and 33.3% for patients with post-operative complications compared with 62.5% and 64.0% in controls (p<0.001). Five-year DFS and OS were 31.4% and 37.3% in patients with raised CRPs compared with 58.5% and 59.5% in controls (p=0.005, p=0.001, respectively). Five-year DFS for CIMpN scores of 0, 1, 2, and 3 were 85.9%, 50.0%, 26.2%, and 15.4% (p<0.001) respectively. On multivariable analysis CIMpN score was independently associated with DFS [HR 3.00, 95% Confidence Interval (CI) 1.90-4.73, p<0.001] and OS [1.93 (1.43-2.59), p<0.001]. Conclusion: A novel composite score, CIMpN, based on SIR, MSS and pN-stage, offers important prognostic signals.

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The Acute Abdomen

Ferrari¹,

Fichera²

2021

Oncologic Emergency Medicine

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Outcomes following small bowel obstruction due to malignancy in the national audit of small bowel obstruction

Cited by 13 publications

References 24 publications

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

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

Prognostic significance of compound combined peri-operative biomarkers in gastric cancer

The Acute Abdomen

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