Palliative Colostomy for End-Stage Gynecologic Cancer

Abstract

Purpose: This study aimed to investigate the use of colostomies to alleviate gastrointestinal symptoms in patients with end-stage gynecologic cancer presenting with malignant bowel obstruction (MBO). Material and Methods: We retrospectively investigated 12 patients undergoing palliative colostomy for MBO due to end-stage gynecological cancer. Two main areas were assessed: i. postoperative complications, the duration of postoperative oral intake, and the postoperative survival; and ii. The effect of the patient's preoperative general condition and nutritional status on postoperative vital prognosis using the palliative prognostic (PaP) score and the prognostic nutritional index (PNI), respectively. Results: Postoperative oral intake was possible for 10 of the 12 patients. The median length of oral intake was 42 (6-150) days and the median duration of postoperative survival after colostomy was 54.5 (14-217) days. All patients died due to disease progression. For the 8 patients in the group with PaP scores under 5.5, the median durations of postoperative oral intake and postoperative survival were 58 and 85.5 days, respectively. For the 4 patients in the group with PaP scores of ≥ 5.5, the corresponding values were 3 and 25.5 days, respectively. For the 10 patients in the group with PNI of <40, the median durations of postoperative oral intake and postoperative survival were 38.5 and 51.5 days, respectively. For the 2 patients in the group with PNI of ≥ 40, the corresponding values were 88 and 183.5 days, respectively. Conclusion: Colostomy performed on patients for MBO due to end-stage gynecological cancer contributed to improved quality of life. The data suggests that the PaP score and PNI may facilitate the prediction of postoperative outcomes.