Section of Gynecologic Oncology, Department of Gynecologic Oncology, University of Chicago Medical Center, Chicago, IL, United States of America.
Section of Gynecologic Oncology, Department of Gynecologic Oncology, University of Chicago Medical Center, Chicago, IL, United States of America.
Gynecol Oncol. 2019 Jul;154(1):177-182. doi: 10.1016/j.ygyno.2019.04.681. Epub 2019 May 2.
To describe and compare treatments and outcomes of patients with malignant bowel obstructions (MBO) due to uterine or ovarian cancer.
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.
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).
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.
描述和比较因子宫或卵巢癌而导致的恶性肠梗阻（MBO）患者的治疗方法和结局。
对 2005 年 1 月 1 日至 2016 年 12 月 31 日期间，因复发性/进展性子宫或卵巢癌而出现 MBO 的 2 家机构的女性患者进行回顾性病历审查。收集的数据包括患者特征、MBO 前后的癌症治疗、MBO 管理策略以及 MBO 后的生存情况。
因子宫癌（n=46）和卵巢癌（n=130）而出现 MBO 的女性患者在内科住院干预方面接受了类似的治疗，如住院化疗和手术。所有患者因 MBO 入院后的中位总生存期（OS）为 105 天，子宫癌患者的 OS 更短（57 天 vs 131 天，p=0.0013）。接受手术的子宫和卵巢癌患者的生存情况相似（182 天 vs 210 天，p=0.6），因 MBO 首次入院时即接受姑息治疗而出院的患者也是如此（26 天 vs 38 天，p=0.1）。接受姑息治疗的子宫和卵巢癌患者的化疗后出院率相似（37% vs 50%，p=0.12），但接受化疗的子宫癌患者的生存情况更差（151 天 vs 225 天，p=0.03）。
MBO 的预后相对较差。接受手术或姑息治疗的卵巢和子宫癌患者具有相似的结局。在未经姑息治疗而接受内科治疗的患者中，子宫癌患者的生存情况更差，即使是那些适合后续化疗的患者也是如此。在这一困难时刻，基于这些发现为患者提供有关护理目标的咨询意见，并结合患者对 MBO 体验的报告和定性数据，将会有所帮助。
