Outcomes following percutaneous upper gastrointestinal decompressive tube placement for malignant bowel obstruction in ovarian cancer

K. S. Rath, D. Loseth, Peter Muscarella, G. S. Phillips, J. M. Fowler, D. M. O'Malley, D. E. Cohn, L. J. Copeland, E. L. Eisenhauer, R. Salani

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective The objective of this study was to evaluate peri-operative and survival outcomes of ovarian cancer patients undergoing percutaneous upper gastrointestinal decompression for malignant bowel obstruction (MBO). Methods Retrospective chart review was used to identify patients with ovarian, peritoneal, or fallopian tube cancer who underwent palliative decompressive treatment for MBO from 1/2002 to 12/2010. Kaplan-Meier methods were used to estimate the median survival (MS) and multivariate analysis used to determine if any variables were associated with the hazard of death. Results Fifty-three patients met inclusion criteria. Median length of diagnosis prior to intervention was 21 months. Fifteen (28.3%) patients experienced complications and 9 required revision. Forty-nine (92.5%) experienced relief of symptoms after placement, and 91% tolerated some form of oral intake. Following placement, 19 (36%) patients received additional chemotherapy and 21(41%) patients received total parental nutrition (TPN). Thirty-five patients were discharged home/outpatient facility, 16 to hospice care, and 2 died prior to discharge. MS for all patients was 46 days. Patients who received chemotherapy had a MS of 169 days compared to 33 days (p < 0.001). We failed to find an association between survival and TPN or performance status. Conclusions Malignant bowel obstruction is a common complication of ovarian cancer. Management is palliative; risks and benefits of any therapy must be considered. Percutaneous decompressive therapy provides relief from associated symptoms, and allows patients to be discharged home. Median survival in this group is limited, and decisions regarding aggressive therapy should be individualized.

Original languageEnglish (US)
Pages (from-to)103-106
Number of pages4
JournalGynecologic Oncology
Volume129
Issue number1
DOIs
StatePublished - Apr 2013
Externally publishedYes

Fingerprint

Ovarian Neoplasms
Survival
Fallopian Tube Neoplasms
Hospice Care
Drug Therapy
Survival Analysis
Decompression
Palliative Care
Outpatients
Therapeutics
Multivariate Analysis

Keywords

  • Malignant bowel obstruction
  • Ovarian cancer
  • Percutaneous gastrostomy tube
  • Upper gastrointestinal decompressive therapy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Outcomes following percutaneous upper gastrointestinal decompressive tube placement for malignant bowel obstruction in ovarian cancer. / Rath, K. S.; Loseth, D.; Muscarella, Peter; Phillips, G. S.; Fowler, J. M.; O'Malley, D. M.; Cohn, D. E.; Copeland, L. J.; Eisenhauer, E. L.; Salani, R.

In: Gynecologic Oncology, Vol. 129, No. 1, 04.2013, p. 103-106.

Research output: Contribution to journalArticle

Rath, KS, Loseth, D, Muscarella, P, Phillips, GS, Fowler, JM, O'Malley, DM, Cohn, DE, Copeland, LJ, Eisenhauer, EL & Salani, R 2013, 'Outcomes following percutaneous upper gastrointestinal decompressive tube placement for malignant bowel obstruction in ovarian cancer', Gynecologic Oncology, vol. 129, no. 1, pp. 103-106. https://doi.org/10.1016/j.ygyno.2013.01.021
Rath, K. S. ; Loseth, D. ; Muscarella, Peter ; Phillips, G. S. ; Fowler, J. M. ; O'Malley, D. M. ; Cohn, D. E. ; Copeland, L. J. ; Eisenhauer, E. L. ; Salani, R. / Outcomes following percutaneous upper gastrointestinal decompressive tube placement for malignant bowel obstruction in ovarian cancer. In: Gynecologic Oncology. 2013 ; Vol. 129, No. 1. pp. 103-106.
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abstract = "Objective The objective of this study was to evaluate peri-operative and survival outcomes of ovarian cancer patients undergoing percutaneous upper gastrointestinal decompression for malignant bowel obstruction (MBO). Methods Retrospective chart review was used to identify patients with ovarian, peritoneal, or fallopian tube cancer who underwent palliative decompressive treatment for MBO from 1/2002 to 12/2010. Kaplan-Meier methods were used to estimate the median survival (MS) and multivariate analysis used to determine if any variables were associated with the hazard of death. Results Fifty-three patients met inclusion criteria. Median length of diagnosis prior to intervention was 21 months. Fifteen (28.3{\%}) patients experienced complications and 9 required revision. Forty-nine (92.5{\%}) experienced relief of symptoms after placement, and 91{\%} tolerated some form of oral intake. Following placement, 19 (36{\%}) patients received additional chemotherapy and 21(41{\%}) patients received total parental nutrition (TPN). Thirty-five patients were discharged home/outpatient facility, 16 to hospice care, and 2 died prior to discharge. MS for all patients was 46 days. Patients who received chemotherapy had a MS of 169 days compared to 33 days (p < 0.001). We failed to find an association between survival and TPN or performance status. Conclusions Malignant bowel obstruction is a common complication of ovarian cancer. Management is palliative; risks and benefits of any therapy must be considered. Percutaneous decompressive therapy provides relief from associated symptoms, and allows patients to be discharged home. Median survival in this group is limited, and decisions regarding aggressive therapy should be individualized.",
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AU - O'Malley, D. M.

AU - Cohn, D. E.

AU - Copeland, L. J.

AU - Eisenhauer, E. L.

AU - Salani, R.

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N2 - Objective The objective of this study was to evaluate peri-operative and survival outcomes of ovarian cancer patients undergoing percutaneous upper gastrointestinal decompression for malignant bowel obstruction (MBO). Methods Retrospective chart review was used to identify patients with ovarian, peritoneal, or fallopian tube cancer who underwent palliative decompressive treatment for MBO from 1/2002 to 12/2010. Kaplan-Meier methods were used to estimate the median survival (MS) and multivariate analysis used to determine if any variables were associated with the hazard of death. Results Fifty-three patients met inclusion criteria. Median length of diagnosis prior to intervention was 21 months. Fifteen (28.3%) patients experienced complications and 9 required revision. Forty-nine (92.5%) experienced relief of symptoms after placement, and 91% tolerated some form of oral intake. Following placement, 19 (36%) patients received additional chemotherapy and 21(41%) patients received total parental nutrition (TPN). Thirty-five patients were discharged home/outpatient facility, 16 to hospice care, and 2 died prior to discharge. MS for all patients was 46 days. Patients who received chemotherapy had a MS of 169 days compared to 33 days (p < 0.001). We failed to find an association between survival and TPN or performance status. Conclusions Malignant bowel obstruction is a common complication of ovarian cancer. Management is palliative; risks and benefits of any therapy must be considered. Percutaneous decompressive therapy provides relief from associated symptoms, and allows patients to be discharged home. Median survival in this group is limited, and decisions regarding aggressive therapy should be individualized.

AB - Objective The objective of this study was to evaluate peri-operative and survival outcomes of ovarian cancer patients undergoing percutaneous upper gastrointestinal decompression for malignant bowel obstruction (MBO). Methods Retrospective chart review was used to identify patients with ovarian, peritoneal, or fallopian tube cancer who underwent palliative decompressive treatment for MBO from 1/2002 to 12/2010. Kaplan-Meier methods were used to estimate the median survival (MS) and multivariate analysis used to determine if any variables were associated with the hazard of death. Results Fifty-three patients met inclusion criteria. Median length of diagnosis prior to intervention was 21 months. Fifteen (28.3%) patients experienced complications and 9 required revision. Forty-nine (92.5%) experienced relief of symptoms after placement, and 91% tolerated some form of oral intake. Following placement, 19 (36%) patients received additional chemotherapy and 21(41%) patients received total parental nutrition (TPN). Thirty-five patients were discharged home/outpatient facility, 16 to hospice care, and 2 died prior to discharge. MS for all patients was 46 days. Patients who received chemotherapy had a MS of 169 days compared to 33 days (p < 0.001). We failed to find an association between survival and TPN or performance status. Conclusions Malignant bowel obstruction is a common complication of ovarian cancer. Management is palliative; risks and benefits of any therapy must be considered. Percutaneous decompressive therapy provides relief from associated symptoms, and allows patients to be discharged home. Median survival in this group is limited, and decisions regarding aggressive therapy should be individualized.

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