[Study of symptoms in terminally ill patients with ovarian carcinoma].

OBJECTIVE

To investigate symptom characteristics and their their prevalence in terminally ill patients with ovarian carcinoma.

METHODS

A retrospective study was carried out based on clinical data of 98 terminally ill patients with ovarian carcinoma who died in our hospital during January 1995 to December 2004. Fifteen most common symptoms were analyzed with a focus on the followings: symptom incidence, survival time after symptom occurrence, regularity of symptom cluster, and common causes of death. Fifteen symptoms were: pain, cachexia, pleural effusion and ascites, dyspnea, fever, intestinal obstruction, renal failure, bone marrow depression, lung infection, hemorrhage, deep venous thrombosis (DVT), intestinal or pancreatic fistula, mycotic infection, jaundice and emergency conditions.

RESULTS

(1) The most prevalent symptom was pleural effusion and ascites (63%), followed by pain (60%), cachexia (59%), dyspnea (52%) and intestinal obstruction (49%). (2) The symptom which lasted longest survival time was mycotic infection (77 days), followed by intestinal or pancreatic fistula (75 days), intestinal obstruction (67 days), pain (60 days) and cachexia (60 days). Symptoms such as bone marrow depression, renal failure, dyspnea and emergency conditions were comparatively critical associated with shorter survival times (14, 13, 12, 7 days, respectively). (3) Terminal symptoms occurred typically in clusters, with 4.9 +/- 1.5 symptoms per case. Of 98 cases, 84 cases (86%) had 4 or more symptoms, with the median survival time of 63 days from the last day of anti-cancer therapy, and a slow death process. The remaining 14 cases (14%) with 3 or fewer symptoms survived only 25 days, of which 10 cases (71%) died of emergency diseases. The survival time for two groups was significantly different (P<0.01). (4) The first four causes of death were as follows: intestinal obstruction (30%), infection (15%), emergencies (12%) and treatment complications (5%).

CONCLUSION

Symptom characteristics and regularity are seen in terminally ill patients with ovarian carcinoma, the understanding of which is helpful for the improvement of symptom management and patients' quality of life.