Survival after Ovarian Cancer-induced Intestinal Obstruction

Piver, M. Steven; Barlow, Joseph J.; Lele, Shashikant; Frank, Allen

doi:10.1097/00006254-198207000-00019

Cited by 11 publications

(17 citation statements)

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“…The overall mortality rate associated with surgery for bowel obstruction from all malignant causes is about 20%, and the rate increases dramatically in malnourished patients or in patients over 70 years ( 18–20). With regard to ovarian cancer patients with intestinal obstruction, the mortality rate within 30 days of surgery ranges from 10 to 25% ( 1–3, 7, 9–11, 21), and the median postoperative survival ranges from 10 to 20 weeks ( 1–3, 7, 9, 10). Our data about operative mortality and survival after obstruction in the surgically treated patients are consistent with the literature.…”

Section: Discussionmentioning

confidence: 99%

Survival after intestinal obstruction in patients with fatal ovarian cancer: Analysis of prognostic variables

Gadducci¹,

Iacconi²,

Fanucchi³

et al. 1998

Int J Gynecol Cancer

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Gadducci A, Iacconi P, Fanucchi A, Cosio S, Miccoli P, Genazzani AR. Survival after intestinal obstruction in patients with fatal ovarian cancer: Analysis of prognostic variables. Int J Gynecol Cancer 1998; 8: 177–182. This study reviewed 67 ovarian cancer patients who developed progressive disease following initial treatment and who died with clinical evidence of tumor. Thirty‐four (50.7%) patients developed an intestinal obstruction during the disease course, and 28 (41.8%) died of this complication. Median interval time from initial diagnosis to obstruction was 19.5 months (range, 6–77 months). Twenty‐two patients were submitted to surgery, whereas 12 received conservative treatment. Median interval time from obstruction to death was 65.5 days (95% confidence interval, 45–99 days; range, 15–699 days). At univariate analysis, survival after obstruction was significantly related to the type of therapy (surgical vs nonsurgical; (P = 0.0011) and to the score based on the criteria proposed by Krebs and Goplerud (including age, nutritional status, tumor status, ascites, previous chemotherapy and previous irradiation; ≤6 vs >6, P = 0.0001), but not to interval time from diagnosis to obstruction, age, number of previous chemotherapy regimens or number of previous operations. Cox model showed that the score was the only independent prognostic variable (P = 0.0003). If a significant palliation from surgery is defined as a survival of at least two months, such benefit was obtained by 87.5% of the 16 patients with a score ≤6 compared to 16.7% of the six patients with a higher score. In conclusion, the decision regarding optimal management of bowel obstruction in ovarian cancer patients should be individualized; however, Krebs' and Goplerud's score seems to offer reliable eligibility criteria for those patients deemed surgical candidates at the time of obstruction.

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Section: Discussionmentioning

confidence: 99%

Survival after intestinal obstruction in patients with fatal ovarian cancer: Analysis of prognostic variables

Gadducci¹,

Iacconi²,

Fanucchi³

et al. 1998

Int J Gynecol Cancer

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“…However, the direction taken here is to determine whether, for our data, other variables play a more important role in postoperative complica- Clinically detected (n-11) 9 (82) 4 (36) 5 (45) *Based on criteria according to Dudrick et al" tions and survival than do the Krebs and Goplerud6 variables, and also to examine the role of these variables in terms of overall survival. Considering the number of variables examined in our sample size of 49 patients and the number of statistical tests performed, analyses of other data will be needed to confirm our results.…”

Section: Methodsmentioning

confidence: 98%

Intestinal Obstruction in Patients With Ovarian Cancer

et al. 1988

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“…Based on current evidence, there is no consensus on the indications for conservative versus surgical treatment of patients with advanced cancer. [109][110][111][112] The consideration for surgical interventions should be individualized, weighing risks and benefits of the procedure. 113 Published data show operative mortality to range from 9% to 40% and complication rates to vary from 9% to 90%.…”

Section: Serotonin Antagonistsmentioning

confidence: 99%

Symptom Control in Palliative Care—Part I: Oncology as a Paradigmatic Example

Dalal

Fabbro

Bruera

2006

Journal of Palliative Medicine

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Achieving the best quality of life for patients and their families when a disease becomes progressive and no longer remains responsive to curative therapy is the primary goal of palliative care. A comprehensive care plan focusing on control of physical symptoms as well as psychological, social, and spiritual issues then becomes paramount in that context. Symptom assessment and treatment are a principle part of palliative care. This paper is the first of three in a series addressing non-pain symptoms, which are frequently encountered in the palliative care populations. The most frequent non-pain symptoms are constipation, chronic nausea and vomiting, anorexia, dyspnea, fatigue, and delirium. As symptoms are subjective, their expression varies from patient to patient, depending on the individual patient's perception and on other factors such as psychosocial issues. While symptoms are addressed individually, patients frequently have multiple coexisting symptoms. Generally told, once the intensity of a symptom has been assessed, it is necessary to assess the symptom in the context of other symptoms such as pain, appetite, fatigue, depression, and anxiety. Given that fact, adopting a multidimensional assessment allows for formulation of a more effective therapeutic strategy. More pertinently, this paper highlights the management of non-pain symptoms as an integral part of patient care and reviews the pathophysiologies, causes, assessment, and management of constipation, chronic nausea, and vomiting, each of which is common among the palliative care population. 391

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Survival after Ovarian Cancer-induced Intestinal Obstruction

Cited by 11 publications

References 0 publications

Survival after intestinal obstruction in patients with fatal ovarian cancer: Analysis of prognostic variables

Survival after intestinal obstruction in patients with fatal ovarian cancer: Analysis of prognostic variables

Intestinal Obstruction in Patients With Ovarian Cancer

Symptom Control in Palliative Care—Part I: Oncology as a Paradigmatic Example

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