Journal Article

EP877 Intestinal (sub)obstruction in ovarian cancer patients: management, complications and survival

Neven, P, Han, SN, Van Nieuwenhuysen, E, Van Gorp, T, Jansen, J, Vergote, I

2019

Overview

Introduction/BackgroundWe aimed to describe management, complications and survival of malignant bowel obstruction (MBO) in epithelial tubo-ovarian cancer patients. Our primary objective was overall survival, measured in days. MBO complications and management were considered secondary endpoints.MethodologyRetrospective monocentric cohort study at the University Hospitals Leuven, Belgium, between January 1st, 2012 until December 31rd, 2016. All primary epithelial tubo-ovarian cancer patients with MBO were identified. The standard conservative approach of MBO in the University Hospitals Leuven is presented in table 1.Abstract EP877 Table 1Standard conservative approach of MBO in the University Hospitals LeuvenNo oral intake of fluid and food Intravenous fluid therapy 2l/24 h Nasogastric tube when necessary Antiemetics e.g. Alizapride (Litican®) Analgesics Octreotide (Sandostatin®) Corticosteroids e.g. Methylprednisolone (Solumedrol®) Abdominal X-ray every two days Results452 patient files were searched from which 48 patients were included in this study with a total of 84 MBO episodes, (median 1 per patient; range 1–5). Median time interval between two MBO episodes was 59 days (range 2–626). Median hospitalization time was 11 days (range 0–74) per episode. Median time interval between cancer diagnosis and first MBO episode was 342 days (range 0–1155). Further characteristics are noted in table 2.Abstract EP877 Table 2Characteristics of MBO in the study population Characteristic Number (n= 48) Time interval between diagnosis and first MBO episode, days; Median (minimum-maximum) 342 (0–1155) Episodes of MBO, n (%); 1; 2; 3; ≥4 27 (56,25); 12 (25); 4 (8,33); 5 (10,42) Episodes of MBO per patient; Median (minimum-maximum) 1 (1–5) Time interval between MBO episodes, days; Median (minimum-maximum) 58,5 (2–626) Hospitalization time per MBO episode, days; Median (minimum-maximum) 11 (0–74) Time to death since the first episode of MBO, days; Median (minimum-maximum) 101 (3–917) Two complications were registeredbowel perforation and bowel ischemia, each in one episode. Conservative treatment was applied in 73 (87%) episodes, including gastrostomy in 3 (4%) episodes. Operative treatment was necessary in 11 (13%) episodes, including exploratory laparoscopy in 2 (2%) episodes and exploratory laparotomy in 9 (11%) episodes. Only one case of postoperative peritonitis was reported. Total parenteral nutrition (TPN) was administered in 15 (31%) patients only. During the study period 35 patients died within a median time interval of 101 days (range 3–917) since the first MBO (figure 1). There was no significant difference in survival between patient groups regarding TPN use, ascites and obstruction at cancer diagnosis.Abstract EP877 Figure 1Kaplan-Meier plot: survival in days from the first episode of malignant (sub)obstruction tConclusionTubo-ovarian cancer patients with MBO have poor prognosis: 73% of our study population died within a relatively short time interval since the first MBO. The majority of patients with MBO were treated conservatively.DisclosureNothing to disclose.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Intestinal obstruction / Intravenous therapy / Medical diagnosis / Medical prognosis / Ostomy / Ovarian cancer / Patients