TY - JOUR
T1 - Malignant bowel obstruction due to uterine or ovarian cancer
T2 - Are there differences in outcome?
AU - Hoppenot, Claire
AU - Peters, Pamela
AU - Cowan, Matthew
AU - Moore, Elena Diaz
AU - Hurteau, Jean
AU - Lee, Nita Karnik
AU - Yamada, S. Diane
N1 - Publisher Copyright:
© 2019
PY - 2019/7
Y1 - 2019/7
N2 - Objectives: To describe and compare treatments and outcomes of patients with malignant bowel obstructions (MBO) due to uterine or ovarian cancer. Methods: Retrospective chart review from two institutions of women admitted 1/1/2005–12/31/2016 with a MBO from recurrent/progressive uterine or ovarian cancer. Data collected includes patient characteristics, cancer-directed treatments before and after MBO, MBO management strategies, and survival after MBO. Results: Women with MBO from uterine cancer (n = 46) and ovarian cancer (n = 130) underwent similar inpatient interventions such as inpatient chemotherapy and surgery. Median overall survival (OS) after admission for MBO for all patients was 105 days and was shorter for uterine cancer patients (57 vs 131 days, p = 0.0013). Uterine and ovarian cancer patients who had surgery had similar survival (182 vs 210 days, p = 0.6), as did those discharged on hospice from their first admission for MBO (26 vs 38 days, p = 0.1). Uterine and ovarian cancer patients had similar rates of post-discharge chemotherapy (37% vs 50%, p = 0.12), but uterine cancer patients who had chemotherapy still had shorter survival (151 vs 225 days, p = 0.03). Conclusions: MBO has a relatively poor prognosis. Ovarian and uterine cancer patients whose interventions included surgery or hospice had similar outcomes. Among patients managed medically without hospice, uterine cancer patients experienced worse survival, even when candidates for subsequent chemotherapy. Patient counseling regarding goals of care at this difficult juncture can be informed by these findings and will be enhanced by patient-reported and qualitative data on the patient experience with MBO.
AB - Objectives: To describe and compare treatments and outcomes of patients with malignant bowel obstructions (MBO) due to uterine or ovarian cancer. Methods: Retrospective chart review from two institutions of women admitted 1/1/2005–12/31/2016 with a MBO from recurrent/progressive uterine or ovarian cancer. Data collected includes patient characteristics, cancer-directed treatments before and after MBO, MBO management strategies, and survival after MBO. Results: Women with MBO from uterine cancer (n = 46) and ovarian cancer (n = 130) underwent similar inpatient interventions such as inpatient chemotherapy and surgery. Median overall survival (OS) after admission for MBO for all patients was 105 days and was shorter for uterine cancer patients (57 vs 131 days, p = 0.0013). Uterine and ovarian cancer patients who had surgery had similar survival (182 vs 210 days, p = 0.6), as did those discharged on hospice from their first admission for MBO (26 vs 38 days, p = 0.1). Uterine and ovarian cancer patients had similar rates of post-discharge chemotherapy (37% vs 50%, p = 0.12), but uterine cancer patients who had chemotherapy still had shorter survival (151 vs 225 days, p = 0.03). Conclusions: MBO has a relatively poor prognosis. Ovarian and uterine cancer patients whose interventions included surgery or hospice had similar outcomes. Among patients managed medically without hospice, uterine cancer patients experienced worse survival, even when candidates for subsequent chemotherapy. Patient counseling regarding goals of care at this difficult juncture can be informed by these findings and will be enhanced by patient-reported and qualitative data on the patient experience with MBO.
KW - Malignant bowel obstruction
KW - Ovarian cancer
KW - Uterine cancer
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U2 - 10.1016/j.ygyno.2019.04.681
DO - 10.1016/j.ygyno.2019.04.681
M3 - Article
C2 - 31056111
AN - SCOPUS:85064896192
SN - 0090-8258
VL - 154
SP - 177
EP - 182
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 1
ER -