Surgery for the resolution of symptoms in malignant bowel obstruction in advanced gynaecological and gastrointestinal cancer

Cousins, Sarah E; Tempest, Emma; Feuer, David

doi:10.1002/14651858.cd002764.pub2

Cited by 94 publications

(94 citation statements)

References 95 publications

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“…One retrospective study showed a survival advantage following surgery for MBO compared with octreotide 272. In a Cochrane systematic review,273 the resolution of the symptoms of MBO following surgery varied from 26.7% to >68%, and successful oral feeding was established in 30–100% of patients. However, reporting on surgical management of MBO needs standardisation, as there are a wide variety of possible surgical techniques and indications 274.…”

Section: Resultsmentioning

confidence: 99%

ESMO–ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease

Colombo

Sessa

Bois

et al. 2019

Int J Gynecol Cancer

357

468

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The development of guidelines is one of the core activities of the European Society for Medical Oncology (ESMO) and European Society of Gynaecologial Oncology (ESGO), as part of the mission of both societies to improve the quality of care for patients with cancer across Europe. ESMO and ESGO jointly developed clinically relevant and evidence-based recommendations in several selected areas in order to improve the quality of care for women with ovarian cancer. The ESMO–ESGO consensus conference on ovarian cancer was held on April 12–14, 2018 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of ovarian cancer. Before the conference, the expert panel worked on five clinically relevant questions regarding ovarian cancer relating to each of the following four areas: pathology and molecular biology, early-stage and borderline tumours, advanced stage disease and recurrent disease. Relevant scientific literature, as identified using a systematic search, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. The recommendations presented here are thus based on the best available evidence and expert agreement. This article presents the recommendations of this ESMO–ESGO consensus conference, together with a summary of evidence supporting each recommendation.

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Section: Resultsmentioning

confidence: 99%

ESMO–ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease

Colombo

Sessa

Bois

et al. 2019

Int J Gynecol Cancer

357

468

View full text Add to dashboard Cite

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“…18 Median reported survivals of patients who have undergone surgery for obstruction range from 4.5 to 8.4 months. 3,6,8,9,15,16,20 On the other hand, our results showed that, in cases where surgical correction was unsuccessful and where a G/J tube was subsequently placed, survival outcomes were clinically more comparable with those who had a G/J tube inserted initially. Indeed, in 1 study, the median survival of women who had an unsuccessful correction attempt was 3.5 months.…”

Section: Discussionmentioning

confidence: 58%

“…9,15 However, this is subjective and provider dependent, and there is no consensus regarding what criteria render a patient a good operative candidate. 16 Some studies have shown a survival advantage for women who undergo surgical intervention, whereas others have not. 4,17,18 In addition, studies have been limited by their small sample size and the fact that they represent single-institution nonrandomized experiences.…”

mentioning

confidence: 99%

Treatment Patterns, Outcomes, and Costs for Bowel Obstruction in Ovarian Cancer

Suidan¹,

He²,

Sun³

et al. 2017

Int J Gynecol Cancer

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Objective To assess treatment patterns, outcomes, and costs for bowel obstruction in ovarian cancer. Methods/materials All patients with stage II–IV ovarian cancer who were admitted for bowel obstruction ≥6 months after cancer diagnosis from 2000–2011 were identified from the Surveillance, Epidemiology, and End Results registry (SEER)–Medicare database. Management strategies and outcomes of bowel obstruction were compared. Results Among 1,397 women with bowel obstruction, 562 (40%) underwent surgery and 154 (11%) had a gastrostomy or jejunostomy (G/J) tube placed. 34% of patients who underwent surgery subsequently received chemotherapy, compared to 8% of those managed with a G/J tube (OR 4.8, 95% CI 2.7-8.8). 30-day complications were higher for patients in the surgery group compared to the tube group (69% vs 46%, OR 2.5, 95% CI 1.8-3.7), as were mean adjusted 30-day total costs ($28,872 vs $18,528, p<.001). Median survival was greater for women who underwent surgery compared to those who had a G/J tube (5.3 vs 1.2 months; adjusted HR 0.31, 95%CI 0.25-0.38). The median survival of patients in whom surgical correction failed and required G/J tube placement during the same inpatient admission was 2.6 months. Women who received post-intervention chemotherapy had improved survival compared to those who did not in both the surgery (17.0 vs 2.8 months, p<.001) and G/J tube groups (5.7 vs 1.0 months, p<.001). Conclusions In women with ovarian cancer who develop bowel obstruction, surgery may benefit a subset of patients, likely related to the ability to receive subsequent chemotherapy. Efforts to identify those who derive no benefit may reduce unnecessary laparotomy, along with its associated complications and costs. Given this population’s limited survival, patient preferences should be evaluated in future studies assessing the management of bowel obstruction.

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“…12 Nevertheless, a palliative operation followed by chemotherapy should be discussed with patients as a valuable option. The vast majority of reported studies had a high risk of bias.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the heterogeneity of outcomes severely limited the conclusions that could be drawn. 12 Nevertheless, a palliative operation followed by chemotherapy should be discussed with patients as a valuable option.…”

Section: Introductionmentioning

confidence: 99%

Surgery in recurrent ovarian cancer

Sehouli

Grabowski

2019

Cancer

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Ovarian cancer is one of the most challenging diseases in gynecologic oncology. The presentation of frequent recurrences requires the establishment and further development of therapy standards for this patient group. Surgery is crucial in the therapy of patients with primary ovarian cancer, and the postoperative residual tumor mass is the most relevant clinical prognostic factor. The surgical management of recurrent disease is still subject to an emotional international discussion. Only a few prospective clinical trials focused on the effects of surgery in relapsed ovarian cancer have been published. The available data show improvements in the prognosis due to complete cytoreduction in the setting of recurrence. However, the selection of eligible patients is the essential issue. Therefore, the establishment of reliable predictive factors for complete tumor resection as well as a definition of the group of patients who might profit from this approach remains a field for research. Further randomized trials designed to develop and incorporate operative standards for recurrent ovarian cancer should follow. Cancer 2019;125:4598-4601.

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Surgery for the resolution of symptoms in malignant bowel obstruction in advanced gynaecological and gastrointestinal cancer

Cited by 94 publications

References 95 publications

ESMO–ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease

ESMO–ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease

Treatment Patterns, Outcomes, and Costs for Bowel Obstruction in Ovarian Cancer

Surgery in recurrent ovarian cancer

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