Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Apr;129(1):107-12.
doi: 10.1016/j.ygyno.2012.12.028. Epub 2012 Dec 26.

Bowel obstruction in elderly ovarian cancer patients: a population-based study

Stephen J Mooney  1 , Megan Winner, Dawn L Hershman, Jason D Wright, Daniel L Feingold, John D Allendorf, Alfred I Neugut
Affiliations

Bowel obstruction in elderly ovarian cancer patients: a population-based study

Stephen J Mooney et al. Gynecol Oncol. 2013 Apr.

Abstract

Purpose: Bowel obstruction is a common pre-terminal event in abdominal/pelvic cancer that has mainly been described in small single-institution studies. We used a large, population-based database to investigate the incidence, management, and outcomes of obstruction in ovarian cancer patients.

Patients and methods: We identified patients with stages IC-IV ovarian cancer, aged 65 years or older, in the Surveillance, Epidemiology and End Results (SEER)-Medicare database diagnosed between January 1, 1991 and December 31, 2005. We modeled predictors of inpatient hospitalization for bowel obstruction after cancer diagnosis, categorized management of obstruction, and analyzed the associations between treatment for obstruction and outcomes.

Results: Of 8607 women with ovarian cancer, 1518 (17.6%) were hospitalized for obstruction subsequent to cancer diagnosis. Obstruction at cancer diagnosis (HR=2.17, 95%CI: 1.86-2.52) and mucinous tumor histology (HR=1.45, 95%CI: 1.15-1.83) were associated with increased risk of subsequent obstruction. Surgical management of obstruction was associated with lower 30-day mortality (13.4% in women managed surgically vs. 20.2% in women managed non-surgically), but equivalent survival after 30 days and equivalent rates of post-obstruction chemotherapy. Median post-obstruction survival was 382 days in women with obstructions of adhesive origin and 93 days in others.

Conclusion: In this large-scale, population-based assessment of patients with advanced ovarian cancer, nearly 20% of women developed bowel obstruction after cancer diagnosis. While obstruction due to adhesions did not signal the end of life, all other obstructions were pre-terminal events for the majority of patients regardless of treatment.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to disclose.

References

    1. Ripamonti C, et al. Clinical-practice recommendations for the management of bowel obstruction in patients with end-stage cancer. Support Care Cancer. 2001;9(4):223– 33. - PubMed
    1. DeBernardo R. Surgical management of malignant bowel obstruction: strategies toward palliation of patients with advanced cancer. Curr Oncol Rep. 2009;11(4):287–92. - PubMed
    1. Feuer DJ, et al. Systematic review of surgery in malignant bowel obstruction in advanced gynecological and gastrointestinal cancer. The Systematic Review Steering Committee. Gynecol Oncol. 1999;75(3):313–22. - PubMed
    1. Clarke-Pearson DL. Surgical management of intestinal obstruction in ovarian cancer. I. Clinical features, postoperative complications, and survival. Gynecologic oncology. 1987;26(1):11–8. - PubMed
    1. Pothuri B. Palliative surgery for bowel obstruction in recurrent ovarian cancer: an updated series. Gynecologic oncology. 2003;89(2):306–13. - PubMed

Publication types