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Malignant bowel obstruction in recurrent gynecologic cancers: who will benefit from palliative surgical intervention? |
Rie Nakamura1, Yuko Shimoji1, Tadaharu Nakasone1, Yusuke Taira1, Yoshihisa Arakaki1, Tomoko Nakamoto1, Keiko Mekaru1, Wataru Kudaka1, Tatsuya Kinjo2, Yoichi Aoki1, *( ) |
1Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara Nishihara, Okinawa 903-0215, Japan 2Department of Digestive and General Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara Nishihara Okinawa 903-0215, Japan |
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Abstract
Purpose of Investigation: To define factors that assist in the selection of patients with gynecologic cancer who have malignant bowel obstruction (MBO) for those who are most likely to benefit from palliative bowel surgery. Materials and Methods: Between 2004 and 2014, 11 women who underwent surgery for bowel obstruction after a discharge for the treatment of gynecologic cancer were included. The diagnosis of MBO was confirmed by symptoms and signs of intestinal obstruction along with abdominal X-ray, or a computed tomography (CT) scan. Results: The median age of women was 58 years and the median time to surgery was six days. Colostomy was performed in seven of eleven patients, ileostomy in three, and bowel resection and anastomosis in two. Postoperative oral intake was achieved in ten of eleven cases, with a median period of 77 (range, 27–224) days. The progression free interval (PFI) of the primary cancer was < 6 months in six patients and ≥ 6 months in five. The median duration of post-operative oral intake in patients with PFI of < 6 and ≥ 6 months was 34.5 (range, 0–65), and 120 (range, 89–224) days, respectively (p = 0.0014). The median survival time after surgery in patients with PFI of < 6 and ≥ 6 months was 43 (range, 11–111), and 156 (range 94–253) days, respectively (p = 0.0206). Conclusion: PFI of primary gynecologic cancer is a good indicator that could help select for those patients who would most likely benefit from palliative bowel surgery. Surgery for MBO should be considered for patients without serious contraindications.
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Submitted: 29 October 2018
Accepted: 21 January 2019
Published: 15 August 2020
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*Corresponding Author(s):
YOICHI AOKI
E-mail: yoichi@med.u-ryukyu.ac.jp
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Cite this article:
Rie Nakamura, Yuko Shimoji, Tadaharu Nakasone, Yusuke Taira, Yoshihisa Arakaki, Tomoko Nakamoto, Keiko Mekaru, Wataru Kudaka, Tatsuya Kinjo, Yoichi Aoki. Malignant bowel obstruction in recurrent gynecologic cancers: who will benefit from palliative surgical intervention?. European Journal of Gynaecological Oncology, 2020, 41(4): 513-516.
URL:
https://ejgo.imrpress.com/EN/10.31083/j.ejgo.2020.04.5070 OR https://ejgo.imrpress.com/EN/Y2020/V41/I4/513
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